83 Forrestal Cir 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 NE)lT DAY INSPECTION: 247-5814
30B INFORMATION:
Job ID: 16-ELEC-2312
Job Type: ELECTRIC ONLY
Desciption: replace weatherhead on service
Estimated Value: $200.00
Issue Date: 10/14/2016
Expiration Date: 4/1212017
PROPERTY ADDRESS:
Address: 83 FORRESTAL CIR
RE Number: 171730-0000
PROPERTY OWNER:
Name: ANDREW 11, JOE H
Address: 541 SOLANA ROD
GENERAL CONTRACTOR INFORMATION:
Name: KNIGHT ELECTRIC LLC
,ER13012523
Address: 908S11THAVE QA MARK STEVEN KNIGHT
Phone:
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Electrical Repairs $35.00
Trade Permit Base Fee $55.00
Total Payments: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC REACH OIWINANCES AND THE FIXHUDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach,FL 32233
Ph(904)247-5926 Fax(904)247-5845
Jon ADDRESS:_ �3 4we*ra'I cimit, 50� PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS JJW AMPS �#J VOLTS PHASE:
VALUEOFWORKS— 204 �
NEW SERVICE EJ Overhead Underground ED Underground up Pole
i Residential(Main)Service
110-100 mpg 1. 101-150amps (.115 1-2DOamps I I amps #of Meters
Commercial(Main)Service
110-100 amps 101-150arrips . 1151-200amps It- amps EICT Service—amps
Conductor Type_ Sim
Multi-Family(Main)Service
to-100 arnpa 1101-150araps it 51-200amps I amps #of Unit Meters
-Temporary Pole I .____jgmps
SERVICE UPGRADE LI—amps I I CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
�1004mps : 1130amps 11200amps I amps r:CTService_Amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outicts/Switches: —0-30amps 3 1-1 00amps —101-200amps
Appliances: —0-30amps 31-100amps —101-200amps
A/C Circuits: 0-60amps _____fi1-I00amps
Hoat Circuits: # circuits
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
Swimminginool 0Sign -Smoke Detectors_(?ty ATransformers KVA OMotm_hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty—volts/amps— VAL UE OF WORK$
REPAIRSIMISCELLANEOUS
Replace Burml/Damaged Motor Can lSafcty Inspection F Panel Change IOR to UG
*15'
ther: roko-u Wa3il k<4 OA/ �e�
Vennit becomes Vold If work does not commence within a six morah period or work Is suspended or atutudoned for six months. I hereby Certify thud 1 have
read this application and know the ssunc to bevrac and correct. All provisions of[am and ordinunces governins this work will be Complied with whoshor
spnifledurnot. The pennit does not Sivt authority to violate the provisions of my other stans or local law reoulation ounumulim,or the pufurounut of
contion,040n.
Phone Number
Property Owners Name Dev 4.0-v,y
Electrical Company 8.4LZWr- L-Ce— —OfricePhone
Co. Address: ith, Atokr 5CA City A4 07bk State fl Zip 7270
Liftst"Holder(Print): =!I. t�rkr— Stat 'fi ' gistration# 701"K23
0 Corn to to
Notarized Signotare of License Holder 7r— %
am"At fore me this day of IYA 20
Noilsv Pub"n"no DOW
3=211;r28i"Ill ignature of Notary Pub ic
ft conm 1�xlts 0 1. ' ti��
Gonusissive 4 EL 64HU T '
CITI OF ATLAWIC BEACH
BUD SEMINOLE RD
ATLANTIC BEK,FL 32233
10114/2016 1418:0
CREDIT CARD
VISA SALE
Card# UWAM614
SEQ 5
W#: 225
INVOICE 5
Approval code 032821
Erty vtow� malual
MDde: Olrkw
Tax Armut $ODO
card Code: 4
SALE AMON $94-00,
CUSTOMER COPY
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH� Fl. 32233
PHONE (904) 247-5B55
Cashier To: atlbcld\atibbja
Receipt Date: 10/14/201b 2:29:12 PM
Receipt Number: OS-71495
Job 10: 16-ELEC-2312 - rep]we weatherhead
on service EDBPR - State Elec DBPR Surcharg
a $Z.DO
Job ID: 16-ELEC-2312 - replace utherhead
an aa�vice EDCA - State Elec DEA Surcharge
$2.00
Job ID: 16-ELEC-2312 - replace weatherhead
an service ELIO - Electrical Repairs $35.
00
Job ID: 1G-ELEC-2312 - replace weatherhead
on service TP - Trade Permit Base Fee $55
.00
Amount Due: $9q.00
Tender Information: Cash $94-00
Tender Type: CC
Tender Amount: S94.00
Change Due: $0.00