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824 SHERRY DR ELEC PERMIT rjyLyYj�;. CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 J;319' ELECTRICAL PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 16-ELEC-1441 Job Type: ELECTRIC ONLY Description: ELECTRIC- KITCHEN AND BATH Estimated Value: $1,200.00 Issue Date: 6/22/2016 Expiration Date: 12/19/2016 PROPERTY ADDRESS: Address: 824 SHERRY DR RE Number: 170392-0000 PROPERTY OWNER: Name: ANDERSON, TIMOTHY Address: 824 SHERRY DR 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 Repairs $35.00 Trade Permit Base Fee $55.00 Total Payments: $94.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC REACH ORDINANCES AND THE FLORIDA BUILDING CODES. ELECTRICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd, Atlantic Beach,FL 32233 Ph(904)247-5826 Fax(904)247-5845 ! -EC-l 4 4 JOB ADDRESS: / r�//t VA. PERMIT# JEA INFORMATION REQUIRED ON ALL PERMITS �i e C AMPS t2 a0 VOLTS PHASE VALUE OF WORK$ 2-" NEW SERVICE ❑ Overhead ❑ Underground ❑f Underground up Pole ❑Residential(Main)Service 00-100 amps 0101-150amps ❑151-200amps ❑ ❑Coamps of Meters mmercial(Main)Service 00-100amps 0101-15(hamps 0151-200amps ❑ Conductor Type Size amps OCT Service amps ❑Multi-Family(Main)Service 00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters ❑Temporary Pole ❑ amps SERVICE UPGRADE ❑_amps ❑ CT Service_amps VEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.) m ❑100aps ❑15oamps ❑200amps ❑ amps OCT Service_amps 1DDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC. Outlets/Switchae $ 0-30amps 31-100amps 101-200amps Appliances: 0-30amps 31-100amps 101-200am s A/C Circuits: 0-60amps 61-100amps p Heat Circuits: #circuits @ kw Number of Lighting Outlets, Including Fixtures: ETHER ELECTRICAL PROJECTS ❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA OMotors_hp IRE ALARM SYSTEM (Requires 3 sets of plans) Qty_volts/amps VALUE OFWORK$ EPAIRS/MISCELLANEOUS ❑Replace B aged Meter Can ❑safety Inspection ❑Panel Change OOH to UG ❑ether " I�/r(JyA � mit bewmes voidIfw rk dow not commence within a six month period or work is suspended m abandoned]for six months. 1 hereby certify that I have I this application and know the some to be true and correct. All provisions of laws and ordinances govemimg this work will be complied with whether ;fried 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 ,unction. perty Owners Name �C�4fen/. Phone Number coital Company / D/!r4r,4 tcdL, 7 �7 �� OfficePho/ � State ne Fax Address: Zl� . � act city LL Zi� Le92 use Holder(Print): —p� Y �Q1 V 6 c to Certification/Registration arize , re Ide :. 69'COWASSION OF 924951 2riiyEXPIaEa:Octabx apy9�� 9mb.ernx(br'wetcueelOSA10 me this dayo Signature of Notary Public I i