1619 Atlantic Beach Dr - Electric , ss, CITY OF ATLANTIC BEACH
Ak s-.) 800 SEMINOLE ROAD
j To - Z 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-1228
Job Type: ELECTRIC ONLY
Description: ELECTRICAL -TEMP POLE
Estimated Value: $300.00
Issue Date: 5/27/2016
Expiration Date: 11/23/2016
PROPERTY ADDRESS:
Address: 1619 ATLANTIC BEACH DR
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: RIVER CITY ELECTRIC
Address: 2825 HOLLYBAY RD QA JOHN REX COOK
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Temporary Electrical Service $35.00
Trade Permit Base Fee $55.00
Total Payments: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACII ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904)247-5845 1 (, —ELE_ ___ I Zzp--)
JOB ADDRESS: 1 Ilo I ck A�\c \\ - �L(.. . C'. Lo# Li PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 6 O AMPS 7-`-kc-, VOLTS I PHASE
VALUE OF WORK$ 3 dO - o
NEW SERVICE D Overhead ®Underground 0 Underground up Pole
0Residential(Main) Service
❑0-100 amps 0101-150amps ❑151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
00-100 amps 0101-150amps ❑151-200amps U amps _;CT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
01);100 amps C 101-150amps ❑151-200amps 0 amps #of Unit Meters
Temporary Pole g (,p amps
SERVICE UPGRADE 0 amps 0 CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100 amps 0 150amps 0200amps 0 amps OCT 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 0 Sign 0 Smoke Detectors Qty Transformers KVA Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
0 Replace Burnt/Damaged Meter Can 0 Safety Inspection 0 Panel Change OOH 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 5\` \ ` 4--CT Phone Number
Electrical Company 2 14 t.( CX \e--Lk i 7 "C.. . Office Phones 1 -ao-7 S Fax
Co. Address:2.e,2-S .\\,..,NO
la
City O t? . Statet.- Zip 32x7 3
License Holder(Print): „DV'-4 Q_, C State Certification/Registration# EC_S(c, $
Notarized Signature of License Holder ,�..— ‘ V
KITTY COOK Swo t subscribed before me this o�A day of 20 )10
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Notary Public- .: CommissionSignature of Notary Public My Comm.Expires Jan 15,2020 '
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