1605 LINKSIDE DR - ELECTRIC 0rL�lrjV�
CITY OF ATLANTIC BEACH
s f 800 SEMINOLE ROAD
; y ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ELEC-1105
Job Type: ELECTRIC ONLY
Description: 1 AC CIRCUIT
Estimated Value:
Issue Date: 5/16/2016
Expiration Date: 11/12/2016
PROPERTY ADDRESS:
Address: 1605 LINKSIDE DR
RE Number: 172374-6105
GENERAL CONTRACTOR INFORMATION:
Name: AMERICAN ELECTRICAL CONTRACTOR
Address: 5065 ST AUGUSTINE RD APT 13 QA EARL W. FRICK
Phone: - -
FEES:
Trade Permit Base Fee $55.00
State Elec DCA Surcharge $2.00
State Elec DBPR Surcharge $2.00
AC Circuits $5.00
Total Payments: $64.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEAC II ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH (.0(.., ,
800 Seminole Rd,Atlantic Beach,FL 32233
r k
f ''//Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: 11.0 C) / t td J) PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS , jC AMPS c9 Y-0 VOLTS 1 PHASE
VALUE OF WORK$ (0,95— O O
NEW SERVICE ❑ Overhead ❑ Underground DJ Underground up Pole
E.Residential(Main)Service
C0-100 amps C 101-150amps 151-200amps C amps #of Meters
0 Commercial(Main) Service
[0-100 amps ';101-150amps -i 151-200amps amps OCT Service amps
Conductor Type Size
72Multi-Family(Main)Service
70-100 amps C 101-150amps I_151-200amps I" amps #of Unit Meters
Temporary Pole L amps
SERVICE UPGRADE _ amps CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
C 100 amps C 150amps l 200amps L amps .ACT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: r 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
[Swimming Pool Sign :Smoke Detectors_Qty :Transformers KVA Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MiSCELLANEOUS
[Replace Burnt/Damaged Meter Can [Safety Inspection -Panel Change IOH to UG
O Other:
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have
read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether
specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of
construction. �i 2 l r�
Property Owners Name ear I a Grow Phone Number qV b -73O.r(IQ/v ti'1
Electrical Company AINlOX l en n t"_IE4C t On I et-y*C1e+t Office P Jho_ne- 739-` 9%Fax d(1-93i/S
Co.Address: ,fit,�S- 3 S4 IC/Sb nom- & City-.baXYJ, ()E. State Ft_ Zip 3 OI'7
License Holder (Print): ECi 1 lA) 1 tC�� State l ' + #ation/Registration# -QI 3�73 I 1
Not,r. " , • . r . '•. •. - ,.der /I1 '
Notary Public Stab of Fbrida if day 20 1 s
i''�� Anna M Daly worn and subscribed before - 4 is y of
' nny C:ms rrI 'g a5o790
'�.. Expires o�nsno�► ignature of Notary Publi• , tI . 4 € /.1 LA10111111
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
PHONE (904) 247-5855
Cashier Id: atlbcld\atlbbja
• Receipt Date: 5/16/2016 11:49:49 AM
Receipt Number: OS-69895
• Job ID: 16-ELEC-1105 - I AC CIRCUIT TP - T
rade Permit Base Fee $55.00
Job ID: 16-ELEC-1105 - 1 AC CIRCUIT EDCA -
State Elec DCA Surcharge $2.00
Job ID: 16-ELEC-1105 - 1 AC CIRCUIT EDBPR
- State Elec DBPR Surcharge $2.00
•
Job ID: 16-ELEC-1105 - 1 AC CIRCUIT EL12 -
AC Circuits $5.00
Amount Due: $64.00
Tender Information: Cash $64.00
Tender Type: CC
Tender Amount: $64.00
Change Due: $0.00