640 Palm Ave 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 NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ELEC-2374
Job Type: ELECTRIC ONLY
Description: replace 4 ceiling fans, replace 7 light fixtures
Estimated Value: $900.00
Issue Date: 10/21/2016
Expiration Date: 4/19/2017
PROPERTY ADDRESS:
Address: 640 PALM AVE
RE Number: 170439-0010
PROPERTY OWNER:
Name: SALT AIR HOMES
Address: 226 TALLWOOD RD JACKSONVILLE BEACH, FL 23250
GENERAL CONTRACTOR INFORMATION:
Name: JAX ELECTRICAL CONTRACTING INC
Paul Carter Keane, EC13006936
Address: 1839 LANE AVE SUITE 110 PAUL KEANE
Phone: -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Lighting Outlets, Including $6.60
Fixtures
Trade Permit Base Fee $55.00
Total Payments: $65.60
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BONDING CODES
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach,FL 32233
L y Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: V `0 PALM AUS. PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
00- mio w-r--
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑f Underground up Pole
❑Residential(Main)Service
00-IOO amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
[]Commercial(Main)Service
00-100 amps 0101-150amps 0151-200amps ❑ amps OCT Service amps
Conductor Type Sim
[]Multi-Family(Main)Service
00-I00amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters_
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps 22 2
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.) LS L 22 F O VppE
❑100 amps ❑150amps 0200amps ❑ amps ❑CT Service ups D
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES, OCT 13 2016
Outlets/Switches: 0-30amps 31-100amps 101- ps
Appliances: 0-30amps 31-100amps 101- 00
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 DMotorsbp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty, volts/amps VALUE OF WORK
REPAIRS/MISCELLANEOUS
❑Replace Bumt/Damaged Meter Can ❑Safety Inspectioon,' )Wanel Change DOH to UG
)LOther: �i;1�IJ)l.Ji H CG+41N� (> � �Gi'1-alu— o6d'Y Fcv rvo�n� .
permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certity that I have
read this application and know the same to be true and wrre 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
Property Owners Name �hTAI F- laowtG—S&IV60— V_42
A4 Phone Number 9041" 333—bbo�
Electrical Company �/icL EkCQ +mk (1r��cocJFrvin�OfficePhonee� t{8i83bHFax
Co.Address: DD��. *a 4F .T V City LCA�!g tvc kk? State-:E(—Zip �a�
License Holder(Print): Yn l 1 1�1 e (,,- State Certification/Registration# Ci!=
Notarized Signature ojLicense Holder
A'sgga, MaW RobWart Before me this 14'�`- _day of ()rSignature of Notary Public
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�2 COMMISSION IFF230743 ✓Vt/yt_
EXPIRES: May 14. 2019
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