1671 Beach Ave - Electrcal ,� y:. : .-' CITY OF ATLANTIC BEACH
J' f 800 SEMINOLE ROAD
`�` V� 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-1243
Job Type: ELECTRIC ONLY
Description: ELECTRICAL REPAIRS - 110 FIXTURES
Estimated Value:
Issue Date: 6/1/2016
Expiration Date: 11/28/2016
PROPERTY ADDRESS:
Address: 1671 BEACH AVE
RE Number: 169658-0000
PROPERTY OWNER:
Name: GAY TRUST, SHIRLEY W
Address: 1671 BEACH AVE
GENERAL CONTRACTOR INFORMATION:
Name: TITAN ELECTRIC GROUP, INC.
Address: 2730 -7 CL CLYDO RD QA CHARLES WILLIAM BELINGHOFF
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Electrical Repairs $35.00
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Trade Permit Base Fee $55.00
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Total Payments: $94.00
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PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233 G
Ph(904) 247-5826 Fax (904)247-5845 I -E -I Z4 3
JOB ADDRESS: i 6 7 f �t, A
./L PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 2 00 AMPS tAO VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑l Underground up Pole
Residential(Main) Service
1 '.0-100 amps 7101-150amps i 1151-200amps I I amps #of Meters
Commercial(Main) Service
1 :0-100 amps 1101-150amps 151-200amps [ 1 amps I ICT Service amps
Conductor Type Size
:Multi-Family(Main)Service
[ 10-100 amps 101-150amps 1151-200amps 1i amps #of Unit Meters
I Temporary Pole ` amps
SERVICE UPGRADE : : amps I I CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps 1150amps I200amps 11 amps [-CT Service amps
ADDITIONS,REMODE5,,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: -TV 0-30amps 31-100amps 101-200amps
Appliances: £ 0-30amps 31-100amps 101-200amps
AIC Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures: U,V
OTHER ELECTRICAL PROJECTS
Swimming Pool -1 Sign Smoke Detectors Qty 1Transformers KVA ` Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
1Replace Burnt/Damaged Meter Can Safety In
spection [ Panel
Change
DOH to JG
lOther:W WkU.Cif -CCe1 ") ,WI i igteviks(e/ti.k6) mottia
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. 7 nn //'' y�/
Property Owners Name LI^n a, t r ke-51�)t h 6 L Phone Number(CKA)0 \-0
Electrical CompanyThiAl alrl ettc,b I C- -0 v.e Office PhonR0 4 361 acol(o Fax9 O430 C1544
Co. Address: 2-71CW coo NA• CityickekSon v t k State FL- Zip 322o 1
License Holder (Print):O l0k-S. W . .\ t'n Ol V1 o-c- State .. ' .at ' egistration # EG,' o�32(O2-
Notarized Signature ofLicense Holder J 4/ • 3,
g /
Denise A.Ennis. iii, .4 I dayof (ul 20 I C
ARY PUBUC Sworn and subscribed before mil
` Irod • STATE OF FLORIDA
1,1"1"t; CemnM FFNi42i
' Signature of Notary Public_
Expires 3/1/2020
Alk Bosco Building Contractors, Inc.
2158 Mayport Road, Atlantic Beach, Florida 32233
PURCHASE ORDER
DATE: May 30, 2016 PURCHASE ORDER NO. 17-16
VENDOR: JOB NAME:
The Titan Electric Group, Inc. Dunayer Residence
1671 Beach Ave, Atlantic Beach, FL
Scope of Work: Renovation
1. Adding misc. fixtures
2. Changing fixtures
••All work to be completed in a workmanlike manner according to standard practices and local codes.
••Any Alterations and or Deviation from the Drawings or Specifications involving additional costs or otherwise,
must be Approved by Bosco Building Contractors, Inc.
••Any Employee that is on the Job must be fully covered by Workers Compensation Insurance.
••All subcontractors are responsible for cleaning their work area on a daily basis.
••All Invoices must refer to Purchase Order 417-16; any Invoice without the referenced Purchase Order number
will not be processed.
**All invoices will be paid when funded by Owner.
TOTAL: COST/PLUS
Accepted/Ap..:
By:
By:
TOf515-BO 0, PRESIDENT The Titan Electric Group, Inc
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Phone: 904.241.0320 Fax: 904.241.0326 Email: Info@BoscoCBC.com CBC 1250212
www.BoscoCBC.com
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