1237 MAYPORT RD - ELECTRIC SAFETY r,:y .\S, CITY OF ATLANTIC BEACH
< '' f 800 SEMINOLE ROAD
Ja Al. . t .)
t) ATLANTIC BEACH, FL 32233
/ INSPECTION PHONE LINE 247-5814
\0:319''
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ELEC-1808
Job Type: ELECTRIC ONLY
Description: safety inspection - JEA needs to tap up & meter set
Estimated Value: $400.00
Issue Date: 8/9/2016
Expiration Date: 2/5/2017
PROPERTY ADDRESS:
Address: 1237 MAYPORT RD
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: CURRENT ELECTRICAL CONTRACTORS
Address: 11787 WORDSWORTH CT QA MARK J NECHVATAL
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904)247-5845
JOB ADDRESS: I a 3 7 MAS eoR.� �4 . PERMIT# llo"6LEt—
JEA INFORMATION REQUIRED ON ALL PERMITS 1 S0 AMPS Z'-,o VOLTS I PHASE
VALUE OF WORK$ tip° -°°
NEW SERVICE ❑ Overhead ❑ Underground ❑J Underground up Pole
❑Residential(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
00-100 amps ❑101-150amps ❑151-200amps 0 amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps ❑101-150amps ❑151-200amps _ amps # of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps Li 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 Ci 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 DOH to UG
pother: 4f 006• c]EA, w)ems '40 #P a p •. nr.e.4-en, S e...*
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 t R1 4. R-Q A i i l Phone Number 3'4°I -1 17
Electrical Company C�A.rze.,+ t I Q c. .c..m C Co,i4... a-,c Office Phone -1a".2>s-Se. Fax
Co.Address: 1114) I l.,3o lst.,c)._+t,, C'r. City Jretv-sG.,v'•ik� State Ft-- Zip 3 - 2 1
License Holder(Print): MAR..- (J ¢xc- -,A•'L4.t State Certification/Registration# EC f3oosc.9 S
Notarized Si, i a , r --- der f (i .)
TONT GINDIESPERGER 1� Z ��j
,: 'r'''' � MY COMMISSION 1 FF 924951 I;efore me this C( day o �1lkik 20
sr. 'N
71 :a EXPIRES.October 6,2019
'�''''' �„eoeThrurraarrPubscunaecers signature of Notary Public