1543 Main St #5 elec safety permit rS"1Urj
= s I CITY OF ATLANTIC BEACH
l 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-2338
Job Type: ELECTRIC ONLY
Description: Unit#5 - safety inspection - 125 amps/480 volts/third
phase
Estimated Value: $350.00
Issue Date: 10/16/2016
Expiration Date: 4/16/2017
PROPERTY ADDRESS:
Address: 1543 MAIN ST
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: HWV MECHANICAL/ELECTRICAL CONTRACTORS
Christopher Hyman,ER13015213
Address: 12797 Wilderness LN
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904) 247-5845 I b- L, 33g
JOB ADDRESS: I S t13 s M,t,- S+r,,j Allga l (}r.pA PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 17,5'" AMPS UK'h VOLTS 3 PHASE
VALUE OF WORK$_ 3YJ1L
NEW SERVICE ❑ Overhead ❑ Underground ❑J Underground up Pole
❑Residential(Main)Service
00-100 amps 0101-150amps 0151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
❑Multi-Family(Main) Service
00-100 amps 0101-150amps 7151-200amps ❑ 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: 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:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motorsbp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can Aafety Inspection ❑Panel Change ❑OH to UG
OOther:
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 ofany other state or local law regulation construction or the performance of
construction.
Property Owners Name ('w Pro �^ 1 n Phone Number
Electrical Compaany A w V 61..{.._q I P A-4,,a ( ronNt.(rK ur. Office Phone q Fax
Co.Address: X(13 CtptASS ",A 0, City State R. Zip 3AXC&
License Holder(Print): ars{r(i✓/ . ...vn/ State Certification/Registration# B $l� I I a I 213
Notarized Si nature of License Holder / 1±1.1 .I
,jl"'M�'; ar °cae synN�r ,,B ore me this I6',day of C LO 20�
- EXPIRES:�u9as1],A" 19� C�
6o VIRS:Acial 7muw�ni afore of Notary Public Cl1{4nrf. .UXY+Ww