341 6th St elec permit (2) � �S I,yL`J jjr
CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
stir '
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: 108E 27th ST OA 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: $64.00
PERMIT ES APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORDIA
BUILDING CODES
�$xr%Ir77jn'.
�5 ATLANTIC BEACH
PERMIT RECEIPT
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PERMIT DESCRIPTION: remodel/repair A/C circuits \O
PERMIT NUMBER: 16-ELEC-1892 QP 9 tip�6 cN
ADDRESS: 3416TH ST
OWNER:
DATE ISSUED:
FEES DUE:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
AC Circuits $5,00
CITY OF ATLANTIC BEACH
$55.00
Trade Permit Base Fee 810 SEMINOLE RD
ATLANTIC BEAC,R 37233
08;1917016 14:17:09
Totals: CREDIT CARD
$64.00 NSA SAIF
CARDS XXXXX.XXJCX )2383
INVOICE 0005
SEQ k', 0005
Bach n', 000383
Approval Code, 0128BG
b ty Metlwd: M"
Mode', Croft
Tax Amami: $0.00
Card Code: M
SALE AMOUNT sm
CUSTOMER COPY
ELECTRICAL PERMIT APPLICATION
CrrY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach,FL 32233
'34
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: 341 Ut c - 1 N,aM%W%1fl, VMVS PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 100 ANTS
n, 40 VOLTS I PHASE
W
VALUE OF WORK$_ Off"
NEW SERVICE ❑ Overhead ❑ Underground ❑J Underground up Pole
F Residential(Main)Service
-0-100 amps G 101-150amps 151-200amps -_amps #of Meters
L Commercial(Main)Service
' 0-100 amps 0101-150amps -151-200amps -_amps .CT Service amps
Conductor Type Size
,Multi-Family(Main)Service
L0-Woamps 0101-150amps -i151-200amps = amps of Unit Metas
]Temporary Pole =_amps
SERVICE UPGRADE =_amps LCT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
D 100 amps 150amps -200amps Lamps =CT 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 Q_kw
Numbs of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
,Swimming Pool = Sign -Smoke Detectors_Qty JTmnsformers KVA -)Motors_hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty_volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
-Replace Burnt/Danaged Meta Can ]Safety Inspection --Panel Change OH to UO
Other:
Permit hecomes void if work does not commence within a six month period or work is suspended or abandoned for sin months. 1 hereby certify that I have
read this application and know the same lobe tone and correct. All provisions of laws and ordinances goveming this work will be complied with wbctber
specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation wnstruction or the performance of
construction.
Property Owners Name�J a rn J &S Phone Number j.W' LrS1 . 15101
Electrical Company11 01MMA FiItOWC 0+_ NF1_ Office Phone 353' 1500 Fax Ztj3' 217
Co. Address: 10% F 211K fit. City Mt. Stateft-- Zip'SUOt
License Holder(Print): lFud 71hompSon do gistration#Ei 1 038
N ' 11111! Icier
MY COMMISSEMOFF993295 Sw mand subscribed efore me,this do
„+` EXPIRES May t),2930'
twlireaw raewe.ra.�aw, Signature of Notary Public_ /