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325 Country Club Ln new elec permit CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 -f INSPECTION PHONE LINE 247-5814 ELECTRICAL PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 ]OBINFORMATION: Job ID: 16-ELEC-2382 Job Type: ELECTRIC ONLY Description: new electrical service - 300 amps/240 volts/ single phase Estimated Value: $3,000.00 Issue Date: 10/24/2016 Expiration Date: 4/22/2017 PROPERTY ADDRESS: Address: 325 COUNTRY CLUB LN RE Number. 171962-0000 PROPERTY OWNER: Name: GROVER JR, WILLIAM HOWE Address: 325 COUNTRY CLUB LN GENERAL CONTRACTOR INFORMATION: Name: MUNSON & BRYAN ELECTRICAL CO. ,EC0001795 Address: 3434 ST AUGUSTINE RD QA JOHN MICHAEL SCIOLINO Phone: - FEES: State Elec DBPR Surcharge $2.00 State Elec DCA Surcharge $2.00 New Single Family Electrical $90.00 Trade Permit Base Fee $55.00 Total Payments: $149.00 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 .{Phh(904)247-5826 Fax (904)247-5845 JOB ADDRESS: 3 7—s ��`r^'7% C/fid le.,a PERMTT# JEA INFORMATION REQUIRED ON ALL PERMITS dO AMPS ZYo VOLTS / PHASE VALUE OF WORKSODQ.°� NEW SERVICE 4, Overhead ❑ Underground �I Underground up Pole flkesidential(Main) Service [10-100 amps [1101-150amps ❑151-200amps X -JV amps #of Meters_ I (Commercial(Main)Service 110-100 amps F1101-150amps 0151-200amps ❑ amps El CT Service_amps Conductor Type Size I ]Multi-Family(Main)Service I10-100 amps L1101-150amps 11151-200amps 0-amps #of Unit Meters_ temporary Pok amps SERVICE UPGRADE fJ amps u CT Service amps NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.) I1100amps I1150amps f1200amps fl amps ICTService_amps ADDITIONS,REMODELS,REPAIRS,BUH.D-OUTS,ACCESSORY STRUCTURES,ETC. Outlets/Switches: 0-30amps 31-100amps 101-200amps Appliances: 0-30amps 31-I00amps 101-200amps A/C Circuits: 0-60amps 61-100amps Heat Circuits: # circuits (a3 kw Number of Lighting Outlets, Including Fixtures: OTHER ELECTRICAL PROJECTS HSwimming Pool USign HSmoke Detectors_Qty LITransformers KVA IJMotors_hp FIRE ALARM SYSTEM (Requires 3 sets of plans) Qty_volts/amps VALUE OF WORK 8 REPAH2S/11IISCELLANEOUS I ]Replace Burid/Damaged Meter Can JSafety Inspection ❑Panel Change LIOH to UG I 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 We 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 cunnmction. �� �, 6 y/-G;75-1 `-a Phone Number PropertyOwnersName pp Electrical Company YtlUh5o4 a o/ J"jk f �fCr�%� Office Phone /tty3y1(-�6KFax �j 96�f36 Co.Address: 3-1 �7 .�� �/r�i�SirlG YUA CiTy = o+fiState /r lip License Holder(Print): 54M 5l�dti r, S to Cettificafion/Registration# FG-veo/79S� Notarized Signature of License Holder - JOSEpH GUY CAUCHON Sworn an subscribed before a this a.0 day of 0 " 20EG Como #FF 244625 Esplms July16.2o19 Signature of Notary Public wmmnnrrnu«.rorasrna