303 10TH ST - ELECTRIC (2) ,y t : S\, CITY OF ATLANTIC BEACH
2 800 SEMINOLE ROAD
j 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-2937
Job Type: ELECTRIC ONLY
Description: ELECTRIC - NEW UNDERGROUND SERVICE 200 AMPS, 240
VOLTS, SINGLE PHASE
Estimated Value:
Issue Date: 12/23/2015
Expiration Date: 12/21/2016
PROPERTY ADDRESS:
Address: 303 10TH ST
RE Number: 170063-0000
PROPERTY OWNER:
Name: BOUY, KIM L
Address: 303 10TH ST
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 Heat $2.00
Trade Permit Base Fee $55.00
Total Payments: $61.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
Il'11.1)1NC CODES.
From:Mike Lore Fax (904)373-9018 To: ;90 2475845 2
Fax: +1 (904)2475845 Page 3 of 4 06/24/2016 1:38 PM
06-24-i6; 12:51 ;From: Tc:93739018
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ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
ROO Seminole Rd, Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904)247-5845
JOB ADDRESS: % a s.
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PERMIT#
1N "ORZATTON'REQOtED`:ON ALPYr �w
F.RIYIITS:..0•:. : . PITASL
-----'N _ UE OF WORK LIS;0-0Q
,ANEW SERVICE 1n Overhead Und
;JResldeniil(Main)Service _ and Underground up Pole
D0=100amps []101-150amps 0151-200am s
::Commercial(Main)Service p 0b amps ;<1 of Metas
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10-100 amps Clifll-150aAtps 0151- OOam _
Conductor Type Size p C3 am OCT Service t amps
UMulti-Family(Main)Service -
00-100 amps n 101-150anp5 t.I t 51-200amps 17
Ci•-__ amp amps of Unit Metersttts
OTemporary Pole
SERVICE UPGRADE
Lamps U CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
r3100 amps 0150arnps O200amps 0 amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100am s
Appliances: 0-30amps I01-200aTnps
A/C Circuits: 0-b0atnps s 31"100antps 101-200amps
Heat Circuits:•
p '�'--61-100amps
Number of Lighting Outlets, Including Fixtures:
)TRER ELECTRICAL PROJECTS
flSwimming Fool 0 Sign OSmoke Detectors Qty OTransformers
KVA CMotors hp
IRE ALARM SYSTEM (Requires 3 sets of plans)
Qty -,volts/amps VALUE OF WORK S
EPAIRS/MISCELLANEOUS
ORcplace Bumt/Damaged Meter Can USafety Inspection OPauel Change JOH to UG
COther
:nut boeowec vofd if work does not cornrrtrttce within s six monthperiod or work is suspended or abnndencd for elx months. I hereby certify that t}utve
d this application and know the sane to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether
:rifled or not. The penult docs not give uuthority to vtoista the provisions of any other state or local law regulation construction or the performance of
isrnaction.
)perty Owners Name JoOY
Phone Number
:ctrical Company f�-+11-,-c c I fCag./ • Office Phone 173 PSO Fax r e__
.Address: I A. " Li e:._ 6�4'J.
City PUl3 stated zip 2072-
ense Holder(Print): y _-,. - . 2,4,- ,- eriification/Registration 5a D 6 SZ_
tarized Signature of License Holder "AV iced.-
Before me is :(5/ ►
JAMES M.GADO a day of !/rl Z-
. • NOTARY PU8tgnatureofNotaryPublic t1� ,.gam'' -
�v i- STATE OF FLORIDA
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0"` -' Corms"FF148772 "-
.. : Expires 7/31/2018