850 14th Street West ELECTRIC 5, CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
`Jily 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-1510
Job Type: ELECTRIC ONLY
Description: ELECTRIC - REPAIRS / REMODEL
Estimated Value: $2,500.00
Issue Date: 7/1/2016
Expiration Date: 12/28/2016 _
PROPERTY ADDRESS:
Address: 850 W 14TH ST
RE Number: 171044-0000
PROPERTY OWNER:
Name: LYON, JONATHAN R
Address: 1837 SEA OATS DR
GENERAL CONTRACTOR INFORMATION:
Name: H D LONG ELECTRICAL CONTRACTOR. IN
Address: 1618 HAMMOND BLVD JACKSONVILLE, FLORIDA 32247-5788
Phone: 904-662-0292
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Electrical Repairs $35.00
Trade Permit Base Fee $55.00
Total Payments: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233 I a _EL ._1 S I 0
Ph (904) 247-5826 Fax (904)247-5845 -A
ii ADDRESS: O 50 '1f t .5 I/ z! W e S 7 PERMIT#a-,`ii bT b 9 J
JEA INFORMATION REQUIRED ON ALL PERMITS abb AMPS AY0 VOLTS Siha I- PHASE
VALUE OF WORK$ Z.5—P0
NEW SERVICE ❑ Overhead ❑ Underground UJ Underground up Pole
Residential (Main) Service
'0-100 amps :101-150amps 151-200amps amps # of Meters
Commercial (Main) Service
0-100 amps 101-150arnps 151-200amps amps CT Service_ amps
Conductor Type Size
Multi-Family(Main) Service
0-100 amps 101-150amps 151-200amps _.___amps # of Unit Meters
Temporary, Pole amps
SERVICE UPGRADE amps • CT Service amps
NEW FEEDER (ADDITIONS,ACCESSORY STRUCTURES, ETC.)
100 amps 150amps . 200amps • ________amps CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES, ETC.
Outlets/Switches: :lit 0-30amps 0 31-100amps d 101-200amps
Appliances: 0 0-30amps o 31-100amps 6 101-200amps
A/C Circuits: _ y_0-60amps 0 61-100amps
Heat Circuits: D # circuits @ 0 _ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
Swimming Pool Sign Smoke Detectors_Qty .Transformers KVA Motors �/3 hp
C Ritz l -/-Fik'
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty ___ volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
Replace Burnt/Damaged Meter Can ' Safety Inspection ' •PanelChange OH to UG
Other: r: elC5Vv---fr2 0 /o J
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. n
i2 • Lye A Phone umber 90i-i --4 / 3 L 9 c
Property Owners Name J �n`� 'lit a �'1 y
1 Electrical Company >1 , 1)• L V hj E-11 G t 1 (fa 0i T• -Office o e Fax
Co. Address: 116 18 /n 0 t' s4 /3(VA.' City i ucsoiv WlestateFLZip 32221
License Holder (Print): b. d . ertific. Registration # EC o006 7::-19Notarized Signature of License Holder
.4.40,
•
Sworn and st. . cribed bef•-me thi4M day ofi .ft_. 20 1 1p
Signature of Notary Public ,. : ` Oi _
... Notary Public,Stats of Fbtida
-'-`-' my Comm.Expires Feb.21,2019
Commission No.FF 188676
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