491 SELVA LAKES CIR ELEC PERMIT CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NE)3T DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ELEC-1827
Job Type: ELECTRIC ONLY
Description: ELECTRIC- PANEL CHANGE
Estimated Value: $850.00
Issue Date: 8/11/2016
Ex ip ration Date: 2(7/2017
PROPERTY ADDRESS:
Address: 491 SELVA LAKES CIR
RE Number: 172027-5034
PROPERTY OWNER:
Name: MCCLAMMY, RICHARD
Address: 491 SELVA LAKES CIR
GENERAL CONTRACTOR INFORMATION:
Name: BILL THOMPSON ELECTRIC CO, INC
Address: 49 WEST 7TH ST OA WILLIAM R. THOMPSON, IV
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904)247-5845 - `-' SZ-7
JOB ADDRESS: �yl J Z ke-z 0;(i' PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS ZSO AMPS nZjjNOLTS _�PHASE
VALUEOFWORK$
NEW SERVICE ❑ Overhead ❑ Underground Q!Underground up Pole
❑Residential(Main)Service
00-100 amps 0101-150amps 0151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
00-100 amps [1101-150amps 0151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
OMuld-Family(Main)Service
00-100 amps D101-150amps 13151-200amps El------amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps ❑ amps ❑CT Service_amps
ADDITIONS,REMODELS,REPAIRS,BUH.D-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 ❑Motom_hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qtyvolts/amps VALUE OF WORK$
REPAHLS/MISCELLANEOUS
❑Replace Bumt/Damaged Meter Can ❑Safety Inspection anal Change ❑OH to UG
❑Other:
'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 tbat I have
saad this application and know the same to be tme and coned All provisions of laws and ordinances governing this work will be complied with whether
pacified or not The permit does not give authority to violate the provisions of any other state or local law regulation contraction or the performance of
onswction. //
'ropertyOwners Name—&4 ki �Glm /fe Phone Number
electrical Company a1LL IUOMPSOfI FJ.FI'IYIC g0..Int,. / Office Phone Fax 270-05YO
:o.Address: �6 BFl�IL A +1Pl390150 City State Zip
icense Holder(Print): L State Certification/Registration#
lot eIder
2s' Mi bUM i9
f euavi lmvaexrh,e �9�ma efore me this dayo 2
Signature of Notary Public