381 MAIN ST - SAFETY ELECTRIC I. ' -; CITY OF ATLANTIC BEACH
1-Ky 800 SEMINOLE ROAD
' 't` " 'r ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
119`'
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ELEC-2558
Job Type: ELECTRIC ONLY
Description: safety inspection - 150 amp power off due to water damage
Estimated Value: $75.00
Issue Date: 11/14/2016
Expiration Date: 5/13/2017
PROPERTY ADDRESS:
Address: 381 MAIN ST
RE Number: 170903-0000
PROPERTY OWNER:
Name: NOEL, MARGARET H
Address: 381 MAIN ST
GENERAL CONTRACTOR INFORMATION:
Name: JAGUAR ELECTRIC
, EC0002219
Address: P 0 BOX 7748 QA LOUIS ELLERY HOWARD
Phone: - -
FEES:
Electrical Repairs $35.00
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FI.ORI11 k
BUILDING CODES.
i
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(90j4�).247-5826 Fax(904) 247-5845 S1
JOB ADDRESS: 39 ) )7Q 1 t) S' 1 _ PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS /.,--r-' AMPS ,21/0 VOLTS I PHASE
_., U
VALUE OF WORKS - =-'' /j.52 —
NEW SERVICE ❑ Overhead ❑ Underground [11 Underground up Pole
CResidential(Main)Service
U0-100 amps U 101-150amps L.I 151-200amps t.] amps # of Meters
UCommercial(Main)Service
00-100 amps 0101-I50amps U 151-200amps L. _amps OCT Service�__ amps
Conductor Type Size
0 Multi-Family(Main)Service
00-100 amps 0 101-150amps L?151-200amps [I amps #of Unit Meters
❑Temporary Pole C] amps
SERVICE UPGRADE t I amps L CT Service_ amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0 100 amps 0150amps U200amps U amps f]CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200am ps
I Appliances: 0-30amps 31-I00amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
DSwimming Pool 0 Sign C1 Smoke Detectors_Qty [ Transformers KVA UMotors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
0Replace Burnt/Damaged Meter Can )Safety Inspection Cl Panel Change _[]]OH to UG
i DOther: I! O lq in PC,cc x °cc due, -k2 (.JCtkr C�GY14cJ'-Com,
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.
Property Owners Name I/�' /C r Gr r noLE....., Phone Number
Electrical Company_)Q30 0 r F, 1 e.c-br C- Office Phone 778 ?Sj(Fax �1 n
O? "9X872
Co.Address: 6,1n-30o l 'n Kid le, b U raj ie d City ----I (kX State �'L Zip �' ,7 p��
License Holder(Print): l-0015 1.--b(-3�C /•' State Certification/Registration# 15C " c2a 1
Notarized Signature of License holder �0 (4:3., 4c>"1.O cir & -
�PK�,,,,, STEPHANIE B HUSKISSON Before me this 1/ day •f ove V'I�IL 20
112_
t s..�• ,.o Notary Public-State of Florida 0 i
. �•� Commisabnm #r ff 853666 Signature of Notary Public , // `• .
' ...�-..,: My Comm.Expires Jan 25.2020
„ °`"•,• Bonded through National Notary Assn.