157 BELVEDERE ST ELEC PERMIT CITY OF ATLANTIC BEACH
\sl 800 SEMINOLE ROAD
: ATLANTIC BEACH, FL 32233
/v INSPECTION PHONE LINE 247-5814
\\ 131>r
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ELEC-1474
Job Type: ELECTRIC ONLY
Description: Install ceiling fan in new screen room. 150 AMPS 240 VOLTS.
Estimated Value: $300.00
Issue Date: 6/27/2016
Expiration Date: 12/24/2016
PROPERTY ADDRESS:
Address: 157 BELVEDERE ST
RE Number: 170584-0000
PROPERTY OWNER:
Name: BURCH, ROBERT & LESLEE ANN,
Address: 157 BELVEDERE ST
GENERAL CONTRACTOR INFORMATION:
Name: FIRST CHOICE ELECTRIC INC
Address: 716 N VALLEY FORGE RD QA LAWRENCE DAVID THOMAS
Phone: - -
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233 1 ( -e i__tL 14-7i-/
Ph (904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: / c -7 R.e 1 J e A C trt S—\— PERMIT# 1(o - 93
JEA INFORMATION REQUIRED ON ALL PERMITS 1 Co AMPS 2.4 Q VOLTS I �i PHASE
VALUE OF WORK,$ ... 0>c
NEW SERVICE ❑ Overhead n Underground J Underground up Pole
❑Residential(Main)Service
00-100 amps 0 101-150amps ❑151-200amps 0 amps #of Meters
❑Commercial(Main)Service
00-100 amps 0101-150amps 0151-200amps O amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
[10-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
❑Temporary Pole O amps
SERVICE UPGRADE 0 amps ❑ CT Service amps
%JEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
[1100 amps 0150amps 0200amps ❑ amps OCT Service amps
WDITIONS,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:
Il 'THER ELECTRICAL PROJECTS
0 Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motors hp
[RE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
EPAIRS/MISCELLANEOUS
❑Replace Burnt/Dam11aged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG
❑Other: , .N S rc"....W Cc A Imo, -a-►._ i N 1Vr_� .. r•rr,i•-_e,\ wk
mit becomes void if work does not commence within a si nonth period or work is suspended or abandoned for six months. I hereby certify that I have
I 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
:ified 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
struction.
perty Owners Name Phone Number
ctrical Company 11 i?.... --cC 1,\0 1 c ❑-c-.c;y , c Office Phone .2-4 1,133 ' Fax
Address: —1 1 b ie..Ap.1 Poory Q.c` tJ City K1_e cyl, State L-- Zip 3z2.6k)
•nse Holder (Print): ) �c,_wrI°,t..,cre t A.,0 uvt.AS State Certification/Registration# C C.-201
arize -- - --�
„ L. :,�?' >'= MY COMMISSION#FF 924951 i
18e I e me this 2_ __
' • EXPIRES:October U 201 d/ ��_" 2
A' Bonded Thru Notary Public Undenen ers _ _ _�
'�" Signature of Notary Public, c.2.,` / j