371 Skate Rd - Electric r- - S, CITY OF ATLANTIC BEACH
A j 800 SEMINOLE ROAD
\\,...„,_r x ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
'r4J331!*
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ELEC-1191
Job Type: ELECTRIC ONLY
Description: ELECTRICAL - SERVICE UPGRADE
Estimated Value: $2,100.00
Issue Date: 5/25/2016
Expiration Date: 11/21/2016
PROPERTY ADDRESS:
Address: 371 SKATE RD
RE Number: 171672-0000
PROPERTY OWNER:
Name: NACCA ET AL, RICK V
Address: 456 SKATE RD
GENERAL CONTRACTOR INFORMATION:
Name: DAVID GRAY ELECTRICAL SERVICES INC
Address: 6491 Powers AVE STE 1
Phone: - -
FEES:
Electrical Repairs $35.00
Trade Permit Base Fee $55.00
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Total Payments: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACHV.0
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904)
247-5826 Fax (904) 247-5845 2
JOB ADDRESS: V) 1 cl�'�e, A\-16141(�( . BOA L. 3 33 PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS /,-'0 AMPS D90 VOLTS ) PHASE
VALUE OF WORKS 11100,(1°
NEW SERVICE IYOverhead n Underground nT Underground up Pole
Residential (Main) SeyGice /
0-100 amps 101-150amps 1-51 /SO amps # of Meters
Commercial (Main) Service
0-100 amps 101-150amps 1,51-200amps amps -CT Service amps
Conductor Type_ Size
Multi-Family(Main)Service
0-100 amps _ 101-150amps 1151-200amps amps # of Unit Meters
Temporary Pole amps
SERVICE UPGRADE c zXO amps - CT Service amps
NEW FEEDER(ADDITIONS,ACCESSARY STRUCTURES,ETC.)
100 amps 150amps 00amps -: 2-00 amps CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
Swimming Pool Sign Smoke Detectors Qty :Transformers KVA Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
--Replace Burnt/Damaged Meter Can Safety Inspection Panel Change OH to UG
-_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.
Property Owners Name \i Cy Phone Number qVU o &-F(c)0(P p(
Q o
Electrical Company 1OVI(. € V4� e ci(VK \I fice Phone1Oq- P` srb)I FaxarJOl-3 /
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Co. Address: (999 t j1Ut-Je- 5 l�Ye - City (u,, State rt- Zip 3Z1c)
•
License Holder(Print): &a v1U bh C�►►kh5 State Certification/Registration#_I 306101 M
Notarized Signature of License Holder
ASHLEY FARRIS
NOTARY PUBLIC Sworn and subscribed before me this o' Li day of v ' 20 Ili
STATE OF FLORIDA ,;tt
4 , Cann*FF130506 Signature of Notary Public •
• •. ,
Expires 6/8/2018