262 Seminole Rd elec permit .$Ir1Dyr
�I I 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-2448
Job Type: ELECTRIC ONLY
Description: remodel/repair 113 outlets/switches, move 3 existing
switches & one (1) outlet, move small sub-panel over 12" for new door
Estimated Value:
Issue Date: 11/1/2016
Expiration Date: 4/30/2017
PROPERTY ADDRESS:
Address: 262 SEMINOLE RD
RE Number: 170513-0000
PROPERTY OWNER:
Name: Bossy, Denise
Address: 262 Seminole RD
GENERAL CONTRACTOR INFORMATION:
Name: PURE ENERGY ELECTRICAL SERVICES
, ER13014738
Address: 1017 Avery St ST
Phone: 904-829-5038
FEES:
Lighting Outlets, Including $67.80
Fixtures
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $126.80
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
Ph(904)247-5826 Fax (904)247-5845
JOB ADDRESS:-? Stm "'k6li- R1 PERMIT #
JEA INFORMATION REQUIRED ON ALL PERMITS 200 AMPS Z s G VOLTS s`a31 e PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑f Underground up Pole
❑Residential(Main)Service
110-100 amps D101-150amps ❑151-200amps ❑ amps #of Meters
❑Commercial(Main) Service
110-100 amps 0101-150amps 0151-200amps ❑ amps ❑CTService amps
Conductor Type Sim
❑Multi-Family(Main) Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
❑Temporary Pole []______amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps ❑ amps OCT Service amps
ADDITIONS,REMODELS,REPAIILS,BUHA-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: I/3 0-30dmps 31-100amps 101-200amps
Appliances: 0-30a nps 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$
REPAHLS/MLSCELLANEOUS
❑Replace Burnt/Damaged Meter Can []Safety Inspection ❑Panel Change OOH to UG
,90ther:t ,f- Stv-yc60 d. lo„i•lr•t . P1evr s-rnol sA pAoilyyer 12" 4.e ne. cwt.
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 1 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. (-0A$}rVp4d&j
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Property Owners Name 405iay Drnt'sf Phone Number 611fy-42 h-7416
Electrical Company fvrt EwrrAV Flfc{rq - Office Phone 9dti -g2h-Y03 I Fax
Co.Address: rf" Fed Foy trm; I City Si A-o u3y,e State FI Zip 326
License Holder(Print): tiarl1nnaLrI nvnde(I State Certification/Registration# EQ 130147 kT
Notarized Signature of License Holder Pf dayof Vd
lh 16twMasttuanE Before me this
MYC( MS"#FF01&V
exPRES:May 14•M1] Signature of Not Public
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