168 SEMINOLE RD - ELECTRIC - \J'J f jf-------,, r
,t,��� CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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J,31�r
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ELEC-1765
Job Type: ELECTRIC ONLY
Description: ELECTRIC - REWIRE BATHROOM
Estimated Value:
Issue Date: 8/4/2016
Expiration Date: 1/31/2017
PROPERTY ADDRESS:
Address: 168 SEMINOLE RD
RE Number: 170595-0000
PROPERTY OWNER:
Name: MCKNIGHT, W SCOTT
Address: 168 SEMINOLE RD
GENERAL CONTRACTOR INFORMATION:
Name: ROBBINS ELECTRICAL SERVICES
Address: 7748 NORMANDY BLVD QA MICHAEL DAVID ROBBINS
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
IState Elec DCA Surcharge $2.00
Electrical Repairs $35.00
Trade Permit Base Fee $55.00
Total Payments: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233 4 _ � + , Re-5��
Ph(904)247-5826� Fax (904) 247-5845
.TOB ADDRESS: / 7( 1,4w /'o'2- PERMIT#16 ,4Ae-A7c3
JEA INFORMATION REQUIRED ON ALL PERMITS a07 AMPS ,g go VOLTS l PHASE
VALUE OF WORK S J
NEW SERVICE El Overhead ❑ Underground ❑J Underground up Pole
Ll Residential(Main)Service
00-100 amps ❑101-150amps 0151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
00-100 amps 0101-150amps 0151-200amps ❑ amps CT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps J 101-150amps ❑151-200amps U amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps L CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps 150amps 0200amps ❑ amps OCT Service amps
•
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged`Meterr Can Li
Safety Inspection ❑Panel Change LOH to UG
❑Other: "42/.J.�c_e �/w?"`! Ct.
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 71/ ¢A.ocit.`. Phone Number 'O? .9 Z6
Electrical Company /(o fj6/V.0 E Jr c_ Office Phone /3r- / 77r Faxf DY 28� 92 Lf b
Co.Address: 17 y L `.-L 1 yr 3a3 City itt/ Stat�tj/k Zip
License Holder(Print): tc1L.e4( e+66/VS State Certification/Registration# 1i,3 0/3 70 V
Notarized Signature of License Holder Z3&.. C I '& aii/S/�
p�F,kY��BG DEBRA JEAN Bp1,DWIN Before me this d- : 20 / 6
c MY COMMISSION*FF 201018 J
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,i, EXPIRES:March 31,2019
�• `o Breed Tem Budget Notary Services Signature of Notary Pu•I �,
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