701 Beach Ave #204 elec permit CITY OF ATLANTIC BEACH
r 800 SEMINOLE ROAD
j ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
306INFORMATION:
Job ID: 16-ELEC-2321
Job Type: ELECTRIC ONLY
Description: changing 125 amp panel & breakers, recessed fixtures,
switch receptacles
Estimated Value: $3,875.00
Issue Date: 10/18/2016
Expiration Date: 4/16/2017
PROPERTY ADDRESS:
Address: 701 BEACH AVE 204
RE Number; 170237-0716
PROPERTY OWNER:
Name; VERMILLION TST,CHARLES & SALLY,
Address: 704 BEACH AVE APT 204 704 BEACH AVE #204
GENERAL CONTRACTOR INFORMATION:
Name: BACCK ELECTRIC LLC
Thomas Allen Moore, EC13006749
Address: P O BOX 6053 WILLIAM POWELL MCKINNEY
Phone: -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Multifamily Electrical $50.00
Total Payments: $109.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
4,
,'• � ,d ATLANTIC BEACH
s,
PERMIT RECEIPT
October 17, 2016
PERMIT DESCRIPTION:changing 125 amp panel&breakers, recessed fixtures, switch receptacles
PERMIT NUMBER: 16-ELEC-2321
ADDRESS:701 BEACH AVE 204
OWNER:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Multifamily Electrical $50.00
Totals: $109.00
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ELECTRICAL PERMIT APPLICATION 81Jq TetmQp;4*,p 1 tp
CITY OF ATLANTIC BEACH 14+ W)Z riv0 0
800 Seminole Rd,Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845
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JOB ADDRESS: I l J 1 (mac h A �1e lJl ZLr�'t- PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMM AMPS 24 O VOLTS �_PHASE
y�VALUE OF WORK S
NEW SERVICE El Overhead I YI Underground E3 Underground up Pok
?rvi
:Residential(Main)Sce 7�
0-100 amps . 01-150amps 11151-200amps 11 amps #of Meters
Commercial(Main)Service
.0-100 amps 101-I SOamps : 11 51-200amps ❑ amps CT Service_amps
Conductor Type Sin
Multi-Family(Mai ) rvice
0-100 amps tO1-150mapa ;1151-200amps ❑ amps 9 O Unit Meters
1 :Temporary Pok I amps
SERVICE UPGRADE I iamps ! CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
100 amps :1 I50amps ;1200amps i I amps :!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-I00amps
Heat Circuits: # circuits Q kw
Numher of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
'ISw®mning Pool I1Sign : :Smoke Detectors_Qty (Transformers KVA I (Motors_hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty_volts/amps VALUE OF WOKKf 3875. OF�
REPAIRS/MISCELLANEOUS
Replace Bumt/Dmnaged Meter Can Safety Inspection 1 Panel Change '!OH to UG /
sS'tt;t7't'FIPS
Other: ChGngi of iaS Q 03 AC-I -� 5 OM L.rs, Ce cess -Pjl+ ri
A:10 s , Ce �fs
Pinna becomes void if work does not commence within a sin month period or work is suspended or abandoned for six months. I hereby certify thin I have
read this application and know the same to be tme and ca a All provisions of laws and ordinances governing this work will be complied with whether
specified or of The parrot does not give authority to violate the provisions of my other state or local law regulation curna mmction or the performance of
oretmction. `
Property OwnersName Urry1 Ili Un IST Char1FS 3,AN Phone Number
Electrical Company Igo c.Ck IF Ie[ �(I c L_L, c- Office Phone -1 1 'SO Sa Fax3a3 4(e41.
Co.Address: 53.3 1 d CLIS 4- S} . city Ta x. state-CL Zip a)-3,s4
License Holder(print): Thannay tre state Certification/Regisbalion#ceC(30o 104q
Notarized Signature of License Holder 1 O10jkYbofW
TAMMY L T^Fart Sworn and subscribed before,„�du 0 20
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