65 19TH ST ELEC PERMIT CITY OF ATLANTIC BEACH
'l 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: 16-ELEC-1353
Job Type: ELECTRIC ONLY
Description: ELECTRIC-
Estimated Value:
Issue Date: 6/13/2016
Expiration Date: 12/10/2016
PROPERTY ADDRESS:
Address: 65 19TH ST
RE Number: 169723-1040
PROPERTY OWNER:
Name: SWEENEY,DAVID 8 PATRICIA, `
Address: 65 19TH ST
GENERAL CONTRACTOR INFORMATION:
Name: FRANKLIN ELECTRIC SERVICE
Address: 4 TALLWOOD RD OA JARRETT ADAM FRANKLIN
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: $94.00
PERMIT LS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
14111111111W. .
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
p Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: (0S m-riif
PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS AD(J AMPS GYD VOLTS _
PHASE
VALUEOFWORK$
NEW SERVICE ❑ Overhead ❑ Underground D Underground up Pole
❑Residential(Main)Service
00-100 amps 0101-150amps ❑151-200amps ❑ _
❑Commercial(Main)Service amps #of Meters
00-100 amps 0101-150amps 0151-200amps ❑ amps ❑CT Service_
Conductor Type Size amps
OMuld-Family(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
OTemporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service_amps
tIEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100amps ❑150amps 0200amps ❑ amps OCTService
_amps
"MONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches;: 0-30am s
Appliances: 0-30am s 31-100amps 101-200amps
A/C Circuits: 0-60amps 31-100amps 101-101
Heat Circuits: p 61-100amps
-# circuits @ kw
Number of Lighting Outlets, Including Fixtures:
ETHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty OTransformers
KVA OMotors_hp
IRE ALARM SYSTEM (Requires 3 sets of plans)
Qty_volts/amps
VALUE OFWOR%S
EPAIRS/MISCELLANEOUS
OReplace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UO
OOther: T,yjrAbC 144AJ4 Ga P-A)Ma AI -j-r SVsrt,,,
mit becomes void if work does concomitance within a six month period or work is suspended m abandoned for six months. I hereby certify that I have
I
this application and know the same to be true and comet. Ali provisions oflawe and ordinance
:ified or not. The permit does not give authority to violate the provisions of any other state m local jaw mgniation consing this work truction orel be 'perfo,manced with e of
stmaion.
perty Owners Name Phone Number
cttical Company �2A.JIGUA3 erT/uC Office Phone�Z9- y`/L� Fax
Address: O. `tjox SIZ97 �' .p���
City-�s1Jt C0 State_CL Zip 3Z2y 0
ease Holder(Print): . rfA.)KU/J State Certification/Registration# M30) 506
arized Signatu
;ga':4ye' IAV COMN1SSIlEePFAaE 5 .
i'i;'. F%%flEa:(kfob�r•8,'201 i
� :. .•;,,, saaeetnn twr .Un°^'""°" f Notary Public � '
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