398 11th Street ELECTRICAL CITY OF ATLANTIC BEACH
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800 SEMINOLE ROAD
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: 15-ELEC-995
Job Type: ELECTRIC ONLY
Description: NEW SERVICE
Estimated Value:
Issue Date: 4/29/2015
Expiration Date: 10/26/2015
PROPERTY ADDRESS:
Address: 398 11TH ST
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: ERICKSON ELECTRICAL CONTRACTOR
Address: 2807 ST JOHNS QA FRANK W ERICKSON
Phone• - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
New Single Family Electrical $70.00
Trade Permit Base Fee $55.00
Total Payments: $129.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
From:BOSCO BUILDING CONTRACTORS INC 904 241 0326 04/28/2015 11 :50 #068 P. 001/001
ELECTRICAL PERMIT APPLICATION wKww—
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OF ATLANTIC BEACH 's-5�4W
800 Seminole Rd, Atlantic Beach, FL 32233
(904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: Ph ,
&�M�kUAbklK PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS _aO AMPS AO VOLTS PHASE
VALUE OF WORKS
NEW SERVICE ❑ Overhead ❑ Underground R Underground up Pole
❑Residential(Main)Service �
00-100 amps El101-150amps f/151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
00-100 amps ❑101450amps ❑151-200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
110-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
11100 amps ❑150amps 0200amps ❑ amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
El Swimming Pool ❑ Sign ❑Smoke Detectors_Qty El Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VAL UE OF WORK$
REPAIRS/MISCELLANEOUS
F1 Replace Burnt/Damaged Meter Can ❑Safety Inspection CPanel Change 11 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 of
construction. ruce performance
Property Owners Name9mumv4 Phone Number o* W
Electrical Company Office Phone, Fax ZAA-0'5Z-(P
Co.Address: City State R Zip ZJ �
License Holder (Print): State Certification/Registration#'KLf
Votarized Signature of License Holder
Sworn and suhscrihed before mei thio dnx?,.f in