670 SHERRY DR - ELECTRIC u' , r, 'A„ CITY OF ATLANTIC BEACH
,- ',. " ) 800 SEMINOLE ROAD
J� yr 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-1290
Job Type: ELECTRIC ONLY
Description: ELECTRIC FOR SWIMMING POOL
Estimated Value:
I Issue Date: 6/7/2016
Expiration Date: 12/4/2016
PROPERTY ADDRESS:
Address: 670 SHERRY DR
RE Number: 170398-0000
PROPERTY OWNER:
Name: GORDON, JOHN W
Address: 670 SHERRY DR
1 GENERAL CONTRACTOR INFORMATION:
Name: DAVID PRUETTES ELECTRICAL SVC.
i Address: 331 -8 P PARKRIDGE AVE QA DAVID THOMAS PRUETTE
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
4 State Elec DCA Surcharge $2.00
Swimming Pools $40.00
Trade Permit Base Fee $55.00
Total Payments: $99.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACII ORDINANCES AND THE FLORIDA
BUILDING CODES.
�0...cttSfkoN SOC.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233 •
Ph (904) 247-5826 Fax (904) 247-5845 l 6 -E-`-1- I Z c)O
JOB ADDRESS: t_in° 5hhrN ;' PERMIT#16—R0)-:Me
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead (1 Underground (-1J Underground up Pole
Residential(Main)Service
0-100 amps 101-150amps 151-200amps amps # of Meters
Commercial(Main)Service
0-100 amps 101-150amps 151-200amps amps CT Service amps
Conductor Type Size
Multi-Family(Main)Service
0-100 amps 101-150amps 151-200amps amps #of Unit Meters
Temporary Pole amps
SERVICE UPGRADE amps CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES, ETC.)
100 amps 150amps 200amps amps CT Service amps
ADDITIONS,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:
OTHER,Ef ECTRICAL PROJECTS
., wimming Pool 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 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 1 have
read this application and know the same to be true and correct. All provisions of laws and ordinances governing t-'. . . ' . 'i • er
specified or not. The permit does not give authority to violate the provisions of any other state or local law regul. "`fir" dem-pm-Allman - of
construction. , �� MY COMMISSION N FF153136
��C i Grc‘cli "Fo-- ' EXPIRES:August 21,2018
PropertyOwners Name" c,,_ Phone Nu • :- •
Electrical Company LL1Uici (ute�s f4fcftice -�cVices Office Phone o77. ---1,9a-S FaxXrd--- ci
Co. Address: 331 Parkfl Ault City D( (Lce Parte- State Pt_Zip 37-40ceS
License Holder(Print): lV�d 13n.e -� t rtification/Registration# E(DCX)2523
Notarized Signature of License Holder ..\.,f
P4, ...15 Sworn and subscribed before me this 1'43) y of 3u/Je 20 (CO
iUN N FF153136
3-,;'".*;'.°. ,:,,,:,ins:August 21.2018 Signature of Notary Public