2233 SEMINOLE RD #16 - ELECTRIC UNDERGROUND SERVICE S r\-1`l\.
�" , `sA CITY OF ATLANTIC BEACH
--.1 .1"----.., �2 800 SEMINOLE ROAD
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KI(,,,,,,.._.__y--;r " ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ELEC-1850
Job Type: ELECTRIC ONLY
Description: ELECTRIC - NEW SERVICE 200 AMPS, 240 VOLTS, SINGLE
PHASE
Estimated Value: $5,500.00
Issue Date: 8/15/2016
Expiration Date: 2/11/2017
PROPERTY ADDRESS:
Address: 2233 SEMINOLE RD UNIT 016
RE Number: 169519-0130
PROPERTY OWNER:
Name: NIXON, CHRISTOPHER C
Address: 3301 PERRINS CHASE
GENERAL CONTRACTOR INFORMATION:
Name: CRAWFORD ELECTRIC
Address: P 0 BOX 51045 QA JOHN ROBERT CRAWFORD III
Phone: 904-241-5591
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
New Single Family Electrical $70.00
Trade Permit Base Fee $55.00
Total Payments: $129.00
I
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
Ill III.DING CODES.
'I
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
R0 Seminole-.Rd, Atlantic Bead},-FL 3223-3-- -
11 Ph(904)247-5826 Fax (904) 247-5845 I ( l_,- LEia - I E3S
JOB ADDRESS: o�a 33 Sepik.N o 1{_ (m il /4 PERMIT# /6-n44-c -/Z
JEA INFORMATION REQUIRED ON ALL PERMITS 2Lt7 AMPS 2-'1c- VOLTS f PHASE
VALUE OF WORK$ S7S-uv
NEW SERVICE ❑ Overhead i Underground ❑J Underground up Pole
Residential(Main)Service
00-100 amps 0101-150amps rl51-200amps ❑ amps #of Meters
❑Commercial(Main)Service
❑O-100 amps ❑101-150amps O 151-200amps Li amps OCT Service amps
Conductor Type Size
El Multi-Family(Main)Service
❑O-100 amps ❑101-150amps ❑151-200amps 0 amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE O amps 0 CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps ❑200amps 0 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 0 Sign 0Smoke 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 El Safety Inspection ❑Panel Change DOH to UG
0Other:
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 •2 Phone Number
Electrical Company ( / led?t4 G+t&44 , /..bc.ffice Phone 1I -6.-S t Fax LYO-is 3 7
Co.Address: 2301 l'ArA/S 1_ e....,-.4 Q) City IPL- Staten Zip 3Z2(o4
License Holder(Print): JoItv. R, __. r '�/A i Sta - Certification/Registration# 5C C3oo2G N,
Notarized Signature of License Holder �,��% / _
�; ":;;g, TOMGINDIESPERGE19R for I m, is I Sday o . a_ yA r.,..
.,,., MY COMMISSION t FF gg'�Lgg995511 I
W.; ? EXPIRES:October 6, .i 19 e of Notary Public
3 ,,r Bonded mill Noon Pubic U . _ a , _