1433 Beach Ave electrical permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT;DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ELEC-1187
Job Type: ELECTRIC ONLY
Description: ELECTRICAL - REPLACE METER CAN
Estimated Value: $1,500.00
Issue Date: 5/24/2016
Expiration Date: 11/20/2016
PROPERTY ADDRESS:
Address: 1433 BEACH AVE
RE Number: 170303-0000
PROPERTY OWNER:
Name: MORRIS, MARY UIBLE
Address: 1433 BEACH AVE
GENERAL CONTRACTOR INFORMATION:
Name: LORE ELECTRICAL CONTRACTORS
Address: 210 N ROSCOE BLVD QA MICHAEL LEE LORE
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Electrical Repairs $35.00
Trade Permit Base Fee $55.00
Total Payments: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
? Ph (904) 247-5826 Fax (904) 247-5845 l 62 LEC`l g�
.TOB ADDRESS: �� �� e� �yL— PERMIT#
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
[]Residential(Main) Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
❑Commercial(Main) Service
E10-100 amps 11101-1 50amps ❑151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps 0101-150amps ❑151-200amps ❑ amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 11200amps ❑ amps ❑CT 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: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty LJ Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REP /MISCELLANEOUS
eplace Burnt/Damaged Meter Can ❑Safety Inspection 1_7 Panel Change 11 OH to UG
❑Other:
'ennit 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
ead 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
pecified 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
:onstruction.
'roperty Owners Name / 1 Phone Number
;lectrical Company �nC Cl rZ�lf /ll / JW( . Office Phone 7/?_ Fax 3 –%d1JK
;o. Address: WAR-a"_7 D U City P(/46 State-�/ Zip
Icense Holder (Print): /G _ State Certification/Registration# l 3 o o6 to�Z
Jotarized Signature of License Holder
__121i�� '
TONI GINDLESP , e this day of 2
MY COMMISSION M FF 24951
o= EXPIRES:October 0 p�aft e of Notary Public
Bonded Thru Notary Pubrie Underwriters