341 6TH ST 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 NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ELEC-1892
Job Type: ELECTRIC ONLY
Description: remodel/repair A/C circuits
Estimated Value: $200.00
Issue Date: 8/19/2016
Expiration Date: 2/15/2017
PROPERTY ADDRESS:
Address: 341 6TH ST
RE Number: 169897-0000
PROPERTY OWNER:
Name: PUGH, DEBRA S
Address: 341 6TH ST
GENERAL CONTRACTOR INFORMATION:
Name: THOMPSON ELECTRIC OF N. FL.
Address: 108 E 27th ST CIA FRED M THOMPSON JR
Phone: -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
AC Circuits $5.00
Trade Permit Base Fee $55.00
Total Payments: $64.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES
ATLANTIC BEACH
PERMIT RECEIPT
(fo -vau-
PERMIT DESCRIPTION: remodel/repair A/C circuits n \O
PERMIT NUMBER: 16-ELEC-1892 CG p�-Q,6� 0�C�
ADDRESS: 3416TH ST OF P�Y'P
OWNER: GO
DATE ISSUED:
FEES DUE:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $200
AC Circuits $S•00
CITY OF ATLANTIC BEACH
Trade Permit Base Fee $5500 BN SEMINOLE RD
ATLANTIC BEAC,FL 32233
08,U9ROl6 U:U;09
Totals: CREDIT CARD
$64'00 VISA SAIF
CARD a Kp(XllX%RYx%R2383
INVOICE 0005
SEQ A: 0005
w gO 000383
Agroval Code: 0128BG
Erky www: Muual
Mode: Onlhe
Tar kmurt: $0.00
Cud Code: M
SALE AMOUNT p.w
CUSTOMER COPY
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach,FL 32233
Ph((904)247-5826 Fax(904)247-5845
JOB ADDRESS: �' U 8y, Tlil
• t ANva,&h 1 fl, 5;S PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 00 AMPS''040 VOLTS PHASE
VALUE OF WORK$_ (.VO �
NEW SERVICE ❑ Overhead ❑ Underground ❑i Underground up Pole
LResidential(Main)Service
00-100 amps 101-150amps =151-200amps -_amps #of Meters
7 Commercial(Main)Service
1:0-100 amps 0101-150amps 151-200amps =_amps -CT Service_amps
Conductor Type Size
CMulti-Family(Main)Service
L0-100 amps .101-150amps 7)151-200amps = amps #of Unit Meters
^Temporary Pole ',_amps
SERVICE UPGRADE __amps :1 CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
J100amps 1150amps =200amps Lamps _CT Service amps
ADDITIONS,REMODELS,REPAIRS,BU LD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: __X_0-60amps 61-100amps
Heat Circuits: #circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
CSwimming Pool .- Sign =Smoke Detectors_Qty LTransformers KVA -,Motom_hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
7Replace Burnt/Damaged Meter Can 'L Safety Inspection CPanel Change OH to UG
--Other:
Permit becomes wid if work daft not commence within a six month period or work is suspended or abandoned for six month& I hereby certify that 1 have
read this application and know the same Lobe true and cotrect. All provisions of laws and ordinances governingthis work will be complied with whether
specifiedo,noc Thepermit does not give authority to violate the provisions of any other stateor local law regulation construction or the performance of
construction.
Property Owners Name Tim LA m', Phone Number Reil' U 1
Electrical Company'�I_On M0 A ,1MY4%C 04' N • 7 M Office Phone 353' 1500 Fax 3e�76' 211
Co.Address: w f ill" a�t. o city-'ToaVitt State Ft- zip
zip��
License Holder(Print): a 30n �• tion/ gistration# rzlosb
N A I [der
MV COMMISSION N FF99ND5 SW in and subscribed efore me this* { da rr�of 20��
EXPIRES May 17•2020' �AG:.//<P�.
uar ttmm�•ume.ryw.�a Signature of Notary Public