1270 OCEAN BLVD - ELECTRIC �' "�?, CITY OF ATLANTIC BEACH
�y 800 SEMINOLE ROAD
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c, r� ATLANTIC BEACH, FL 32233
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INSPECTION PHONE LINE 247-5814
EC-1652
LECTRIC ONLY
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
]OB INFORMATION:
Job ID: 16-EL
Job Type: E
Description: ELECTRIC - 12 FIXTURES, 6 OUTLETS
Estimated Value: $4,000.00
Issue Date:
7/21/2016
Expiration Date: 1/17/2017
PROPERTY ADDRESS:
Address: 1270 OCEAN BLVD
RE Number: 171823-0000
PROPERTY OWNER:
Name: STONE,MITCHELL A & CHRISTINE L, *
Address: 1270 OCEAN BLVD
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
Switch Outlets $3.60
Lighting Outlets, Including Fixtures $7.20
Trade Permit Base Fee $55.00
Total Payments: $69.80
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH AL1. ('I"I'\ OF ATLANTIC BEACH ORDINANCES AND TUE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845 ( 6) -E- Lec-`(05Z
JOB ADDRESS: /2 7o a&-77-Ai. 4/f/1` PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS lid VOLTS ( PHASE
VALUE OF WORK$ Vo-v-a
NEW SERVICE ❑ Overhead ❑ Underground DJ Underground up Pole
❑Residential(Main)Service
❑0-100 amps C 1 01-150amps ❑151-200amps H amps #of Meters
LI Commercial(Main)Service
❑0-100 amps C 101-150amps ❑151-200amps II amps ❑CT Service amps
Conductor Type Size
❑Multi-Family(Main)Service 1
00-100 amps ❑101-150amps l 5 l-200amps ❑ amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑l 50amps 0200amps ❑ amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: Io 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: /
Z
OTHER ELECTRICAL PROJECTS
0Swimming Pool 0 Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection LI Panel Change ❑OH to UG
❑Other:
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.
Property Owners Name %/1-16- ' Phone Number
Electrical Y ��L
Com an 6- [`=i ce ,CG9/��' .,A. Office Pone 2 7 //�3 Fax 3V-10/8
Company
Co.Address: 2.16 /i` 7/0S'GO6: v/Ud• City Ir'(J 6 State ?/ Zip.2d 82_
License Holder(Print): f 7/GlteiG/ ) . /-0/1-c-;---
,-( to Certification/Registration# 1.90/302L
Notarized Signature of License Holder 1 .--1-7' '
' '.:,7 TONI GINDLESPERGER Before me this 4Z 1 day of ., 1=' , 20
r- • MY COMMISSION t FF 924951
EXPIRES:October 6.2019 "� 411
*;;;;:q1,.•
� `. Bonded Thru Notary Public Underwrters Signature of Notary Public 9-- r c