109 BEACH AVE MAIN HOUSE - ELECTRIC REPAIR if CITY OF ATLANTIC BEACH
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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-172
Job Type: ELECTRIC ONLY
Description: Repair - 8 Outlets/Switches. 3 Appliances. 6 Outlets, Including
Fixtures
Estimated Value: $900.00
Issue Date: 1/22/2016
Expiration Date: 7/20/2016
PROPERTY ADDRESS: _ t r((J O S
Address: 109 BEACH AVE
RE Number: 170212-0000
PROPERTY OWNER:
Name: FECHTEL FAMILY JNT VENT ET AL
Address: 6830 MEADOW RD
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: $94 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND I III. I I OI(IDA
BUILDING CODES.
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ELECTRICAL PERMIT APPLICATION __. \wt .
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233 \�
Ph(904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: /0 / " &Ct.
AA:7 • PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS Z -0 AMPS 2'j'O VOLTS ( PHASE
VALUE OF WORK$ 4 7ert3
NEW SERVICE ❑ Overhead ❑ Underground 3 Underground up Pole
❑Residential(Main)Service
,70-100 amps 101-150amps 0151-200amps J amps #of Meters
❑Commercial(Main) Service
00-100 amps E 101-150amps 0151-200amps 0 amps El CT Service amps
Conductor Type Size
❑Multi-Family(Main)Service #of Unit Meters
00-100 amps 0101-150amps ❑151-200amps 0 amps
0Temporary Pole ❑ amps
SERVICE UPGRADE U amps U CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100 amps :3150amps E200amps 0 amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 3 0-30amps 31-100amps 101-200amps
Appliances: 3 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures: 6 i
OTHER ELECTRICAL PROJECTS ;
nMotors
0Swimming Pool 0 Sign 0 Smoke Detectors Qty LI Transformers KVA hp
FIRE ALARM SYSTEM (Requires 3 sets of plans) VALUE OF WORK$
Qty volts/amps
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can 0 Safety Inspection ❑Panel Change ❑OH to UG
UOther: Ki A `��
'ermit 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
gad 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
pecified 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
onstruction. 6-l‘
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/ ?1'1 V i Ion.!a Phone Number
'roperty Owners Name/ / � � q
;lectrical Company 1-a/1 c, c/k K/4` �-B'f"�.`4� , Office Phone//277�/V) Fa/x3 73'7o/
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/� Q CityfJJu�/� State 7 Zip 32612
'o. Address: Z/0 /� �S� �` �l U" � / 700669 2
` ,‘, -/ Z. 1-O - ,',,- Certification/Registration# C-C -
icense Holder(Print): �I
Totarized Si Vis.—.n.. • l! AarL
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. `` ;_ Myca 'ssi VC 1 • this Z 2_ day of Ilit, •a, . 20
?'ii'r , ignature of Notary Public Milik •