1543 Main St #8 elec safety permit -ice=1,y-y
CITY OF ATLANTIC BEACH
r 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
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ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
70B INFORMATION:
Job ID: 16-ELEC-2340
Job Type: ELECTRIC ONLY
Description: Unit#8 - 125 amps/480 volts/third phase
Estimated Value: $350.00
Issue Date: 10/18/2016
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: $94.00
PERMIT IS APPROVED ONLY M ACCORDANCE WDTI ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach,FL 32233
Ph(904)247-5826 Fax (904)247-5845
JOB ADDRESS:—1 S'v 3' A4.r 5�-4 /}1I,,,4 6,04 PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS ) ZS AMPS u t10 VOLTS 3 PHASE
VALUE OF WORK$ 1s-0
NEW SERVICE ❑ Overhead ❑ Underground D Underground up Pole
❑Residential(Main)Service
00-100 amps ❑101-150amps 0151-200amps ❑ amps #of Meters_
❑Commercial(Main)Service
00-100 amps 11101-150amps 11151-200amps ❑ amps ❑CTService amps
Conductor Type Size
❑Multi-Family(Main)Service
110-100 amps D101-150amps 0151-200amps ❑ amps 4o Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps 0 CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100 amps ❑150amps 0200amps ❑ amps OCT 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 ❑Motorshp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAILS/MISCELLANEOUS �
❑Replace Burnt/Damaged Meter Can 1-ta ety Inspection ❑Panel Change OOH to UG
❑Other:
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 of any other state or local law regulation construction or the performance of
construction. ff��
PropertyOwners Name� 11 Rr rr> Lr0 Phone Number
Electrical Company F Wv- C4�,Lr 61G Office Phone Ro'I 6-(7 04; Fax
Co.Address: °t1lg Cypr•ss QN`>+^ Or . City State Pf. Zip 32ZTE
License Holder(Print): State Certification/Registration# D0. 130152 11
Notarized Si nature of License Holder
.y °AYNANl1WAW eforemethis Ig day of LttWk 20 It,
MEXPIRES.Asq=, �r-!g j
. Signature ofNotury Public