2251 N Fairway Villas Ln elec permit Y1 y;.1PJr��
{I, CITY OF ATLANTIC BEACH
j 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-2287
lob Type: ELECTRIC ONLY
Description: repair/replace 5 outlets/switches, 10 fixtures
Estimated Value: $4,000.00
Issue Date: 10/12/2016
Expiration Date: 4/10/2017
PROPERTY ADDRESS:
Address: 2251 N FAIRWAY VILLAS LN
RE Number: 169398-1084
PROPERTY OWNER:
Name: Budget Remodeling Contractor LLC
Address: 223 River Run BLVD
GENERAL CONTRACTOR INFORMATION:
Name: PHASE ONE ELECTRIC LLC
Oliver Van De Kamp,EC13005339
Address: 2076 CORONA CT OLIVER VAN DE KAMP
Phone:
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Switch Outlets $3.00
Lighting Outlets, Including $6.00
Fixtures
Trade Permit Base Fee $55.00
Total Payments: $68.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
l Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: er.,2S I Fc�,r L.�r,V V,'(l ce..S PERMIT# / (,2-fZ,�g(i
JEA INFORMATION REQUIRED ON ALL PERMITS / 00 AMPS ad,9b VOLTS PHASE
VALUE OF WORK$—tfoW'
NEW SERVICE ❑ Overhead ❑ Underground ❑J Underground up Pole
❑Residential(Main)Service
110-100 amps [1101-150amps ❑151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
❑0-100 amps ❑101-150amps ❑151-200amps []-Mpg ❑CT Service amps
Conductor Type Size
[]Multi-Family(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps ❑ amps ❑CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: _1'j_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: _0
OTHER ELECTRICAL PROJECTS
[]SwimmingPool ❑ Sign []Smoke Detectors Qty ❑Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Bulrlt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG
'60ther: n&-UIC.P. rinctnolo- oodr
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 one 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. /"� V1Property Owners Name 1 (�qC�1b2C' (3a6Qo tF �Lhne�N
ber
Electrical Company i9kC.,,_ tJn2. j'-'j24'�'C.0 14t-c Office Phone(oSl-f163�/ Fax
Co.Address: d07/, Ctwr-r City State FG zip3CZz--,?-4
License Holder(Print): 4 C4aJ L-"Icolr State Certification/Registration#ec1p0;.Oc8
Notari ed _ older
t•• TONI GINGIESPrAGFA
_iG""�' avrnnw+ssoNtrFezass+ Before methis ' 2 day f 0
' EXPIPES:Oclaber S,2019
grid,' ' a<"a""""°�Pu°"'"i°'"""" Signature of Notary Public