1426 OCEAN BLVD - ELECTRIC �S.1.Ap1:r
* • , t%fay. CITY OF ATLANTIC BEACH
A s) 800 SEMINOLE ROAD
TS)
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
fav
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ELEC-1422
Job Type: ELECTRIC ONLY
Description: ELECTRIC - 15 OUTLETS, 10 FIXTURES
Estimated Value:
Issue Date: 6/21/2016
Expiration Date: 12/18/2016
PROPERTY ADDRESS:
Address: 1426 OCEAN BLVD
RE Number: 171852-0000
PROPERTY OWNER:
Name: MATTHEWS, JOSEPH
Address: 1426 OCEAN BLVD
GENERAL CONTRACTOR INFORMATION:
Name: SEASIDE ELECTRICAL CONTRACTORS
Address: 12381 APPLE LEAF DR QA CLARK GEISSMAN
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: $94.00
PERMIIT IS APPROVED ONLY IN ACCORDANCE WITII AI.I, CITY OF ATLANTIC BEACH ORDINANCES AND TIIE FLORIDA
Ill ILDINc CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845 1 _c L --14 Z
JOB ADDRESS: /VZ CSC .J 13!V
PERMIT# f 6 • W 2
JEA INFORMATION REQUIRED ON ALL PERMITS -t'v AMPS ZylU VOLTS
l PHASE
VALUE OF WORK$
NEW SERVICE 0 Overhead El Underground nT Underground up Pole
❑Residential(Main)Service
00-100 amps 0101-150amps 0151-200amps 0 amps #of Meters
OCommercial(Main)Service
00-100 amps 0101-150amps 0151-200amps ❑ amps
Conductor Type Size OCT Service amps
0Multi-Family(Main)Service
00-100 amps 0101-150amps 0151-200amps ❑ amps #of Unit Meters
0 Temporary Pole 0 amps
SERVICE UPGRADE 0 amps ❑ CT Service amps
VEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100 amps 0150amps 0200amps 0 amps OCT Service
amps
WDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: /S 0-30amps 31-100am s
Appliances: 0-30am s p 101-200amps
p
A/C Circuits: 0-6Oam61-l00amps 101-200amps
Ps 61-100amp s
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures: /0
'THER ELECTRICAL PROJECTS
0 Swimming Pool 0 Sign 0 Smoke Detectors Qty O Transformers
KVA ❑Motors hp
[RE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps • VALUE OF WORK$
EPAIRSNISCELLANEOUS
OReplace Bumt/Damaged Meter Can 0 Safety Inspection ❑Panel Change ❑OH to UG
OOther:
mit 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
I this application and lcnow 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 JO Se
/- M 4 -C''`�4Phone Number
ctrical Company / , / t'f/ecTdet c,d a411. -Cc Office Phone S.-N-00S-- Fax y2`3(1/
Address:/26 20-3 i3e,./ f/1"cf,' • 235 / g
City ��CfbN✓►(� State �L Zip ?22-Y4
nse Holder(Print): fizA, k Xe 1ST, ") State Certification/Registration# 61211)13S]
arize, ... - •—:-07 . . . . ,of ejo �� t
"'i MY COMMISSION 4 FF 924951
L EXPIRES:October 6,2$�fo, me this /'7 day of
:l
t;�'`T' Bonded Thru tJo a4 Pubiiic Underwriters I A I 2
Signature of Notary Public Mil