715 ATLANTIC BLVD - ELECTRIC �� �s, CITY OF ATLANTIC BEACH
� - l 800 SEMINOLE ROAD
� ATLANTIC BEACH, FL 32233
JT INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ELEC-1722
Job Type: ELECTRIC ONLY
Description: ELECTRIC - INSTALL NEW LIGHTING
Estimated Value:
Issue Date: 7/29/2016
Expiration Date: 1/25/2017
PROPERTY ADDRESS:
Address: 715 ATLANTIC BLVD
RE Number: 177541-0000
PROPERTY OWNER:
Name: PREM AND POOJA LLC
Address: 7545 CENTURION PKWY SUITE 204
GENERAL CONTRACTOR INFORMATION:
Name: DEPENDABLE ELECTRICAL
Address: 2009 S JIMMY LN MUKESH T VARDE
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Switch Outlets $6.00
Lighting Outlets, Including Fixtures $24.00
Trade Permit Base Fee $55.00
Total Payments: $89.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AM) 'HIE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach,FL 32233
Ph(904) 247-5826 Fax (904)247-5845
JOB ADDRESS: --\5 IA-0, c- 13x--k cl.,(>r°t-k_c t. c,k,\ <(- Y"-- PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK$
NEW SERVICE D Overhead ❑ Underground ❑T Underground up Pole
❑Residential(Main)Service
00-100 amps 0101-150amps D 151-200amps 0 amps #of Meters
❑Commercial(Main)Service
00-100 amps D 101-150amps D 151-200amps 2 amps OCT Service amps
Conductor Type Size
0 Multi-Family(Main)Service
0O-100 amps D 101-150amps 0151-200amps 0 amps # of Unit Meters
OTemporary Pole D amps
SERVICE UPGRADE 0 amps CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100 amps D 150amps 0200amps 0 amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: ‘.o 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: Utv
OTHER ELECTRICAL PROJECTS
❑Swimming 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 LI Panel Change 011 to llCi
0Other: (A41vA G--}(0exve-wK #...-d •skestt`' maw Crtv►‘Qw.Ayn'‘'-
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 Choy Q ac-e.9\ Phone Number 00 U -A.ek 2- - ck\q'S
Electrical Company C)t-bt e.v404\t- 2k&k' c0• (Di` `Nteil LL L Office Phone`Wk-S 3`-'‘-S 414 4 Fax
Co. Address: 1.06A S''S iw,w.-, \.a.••e 1 Sue.t_suv-o` ve 'F L City '0.(5S-Stv,•A WC. State *---.L- Zip 31 -S-el
License Holder(Print): V'^''`-V--"eS1'` .`'`"r-r)'t_. State Certification/Registration# E' -\;n\`•kWS
Notarize( ,....-----_----4T-1 )lder
TONI GIN❑ SPFAG .
� .efore me this day o' .a A 20
MY COMMISSION t FF 924951
:Pie,",:‘,---1 :•__ EXPIRES:October 6.2019
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Fid MI WM
'"+� d; Bonded Thro NotsY MSc Uide
Pr•... Signature of Notary Public • c —'dUIP