367 Belvedere St elec permit CITY OF ATLANTIC BEACH
it s) 800 SEMINOLE ROAD
I .5 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-1938
Job Type: ELECTRIC ONLY
Description: repair 50 outlets, 3 appliances, a/c circuit, heat circuit
Estimated Value: $5,320.00
Issue Date: 8/25/2016
Expiration Date: 2/21/2017
PROPERTY ADDRESS:
Address: 367 BELVEDERE ST
RE Number: 170703-0266
PROPERTY OWNER:
Name: LINSELL, IAN KETTLEY
Address: PO BOX 330331
GENERAL CONTRACTOR INFORMATION:
Name: PHASE ONE ELECTRIC LLC
, EC13005388
Address: 2076 CORONA CT OLIVER VAN DE KAMP
Phone: -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Electrical Heat $2.00
AC Circuits $5.00
Lighting Outlets, Including $30.00
Fixtures
Trade Permit Base Fee $55.00
Switch Outlets $30.00
Electrical Appliances $6.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WRH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
U
Total Payments: $132.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
RtlllgeminnlP Rri erl�-_ a._.•,*�-Beach-,-FL32233-- ----- - ----
2�^ -7 Ph(904)247-5826 Fax (904)2247-5845
JOB ADDRESS: `X., / ��'ye�P(`P .1��('C�'\ PERMIT# . (Z-152-7
JEA INFORMATION REQUIRED ON ALL PERMITS _V5CLAMPS VOLTS PHASE
VALUE OF WORK
NEW SERVICE ❑ Overhead ❑ Underground ❑l Underground up Pole
❑Residential(Main)Service
00-100 amps 0101-150amps 01St-200amps ❑ amps #of Meters
❑Commercial(Main)Service
110-100 amps 11101-150amps ❑151-200amps ❑ amps ❑CTService amps
Conductor Type Size
❑Multi-Family(Main)Service
❑0-100 amps 0101-150amps ❑151-200amps ❑ amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service_amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps ❑200amps ❑ amps OCTService amps
ADDITIONS,REMODELS REPAIRS,BUHJ)-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: �� -30amps 31-100amps 101-200amps
Appliances: ._-7_0-30amps 31-100amps 101-200amps
A/C Circuits: --A-0-60amps 61-100amps
Heat Circuits: �— # circuits (a3�kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
[]SwimmingPool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA OMotms_hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Bumt/Damaged Meter Can ❑Safety Inspection []Panel Change OOH to UG
❑Other.
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. n Mr t v� Phone Number
\
Electrical Company 6iSea t—`- Cis t L(^ Office Phone Fax
Co.Address: 00-IG C rt: (Ci Crl.r,} City state T--L Zip 32a'1' `}
License Holder(Print): rr4g, State Certification/Begistration# VYJ~]'�\Z9
Notarized Signature ojLicense Holder
TOMGIN01EWP Ma fore me this ay o 0
MYCOAatIS510N rFF924951
F94f.,
nature of Notary Public
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