1249 Beach Ave elec permit -i y'Ly rlr;
r , CITY OF ATLANTIC BEACH
r j 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-2582
Job Type: ELECTRIC ONLY
Description: GARAGE ELECTRIC - 29 FIXTURES, 6 SMOKE
DETECTORS
Estimated Value: $12,600.00
Issue Date: 11/15/2016
Expiration Date: 5/14/2017
PROPERTY ADDRESS:
Address: 1249 BEACH AVE
RE Number: 170292-0000
PROPERTY OWNER:
Name: GST TRUST
Address: 1301 RIVERPLACE BLVD STE 1500 1301 RIVERPLACE
BLVD STE 1500
GENERAL CONTRACTOR INFORMATION:
Name: UNITED ELECTRIC COMPANY OF
Harold Michael Adamson,EC13005367
Address: 5716 ST AUGUSTINE RD QA JOHN E GRIFFIN JR
Phone: -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Wired Smoke Detectors $12.00
Lighting Outlets, Including $17.40
Fixtures
Trade Permit Base Fee $55.00
Total Payments: $88.40
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES
J- 1131
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
Ph(904)247-5826 Fax (904)247-5845. ELcc-�s8
.TOB ADDRESS: I a 4 9 -l B e-a C k A-yt tee_ - PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS V O VOLTS / PHASE
,VALUEOFWORKJ laibof
NEW SERVICE ❑ Overhead ❑ Underground D Underground up Pole
❑Residential(Main)Service
00-100 amps 0101-150amps 0151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
00-100amps ❑101-150amps ❑151-200amps ❑ amps 0 C Service_amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100amps - ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps 0 CT Service_amps
NEW FEEDER(ADDITIONS,.ACCESSORY STRUCTURES,ETC.)
❑100 amps 11150=0 ❑200amps ❑ amps OCT Service_amps
ADDITIONS,REMODELS REPAIRS,BUTA-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: C%� 0-30amps 31-100amps 101-200amps
,Appliances: V 0-30amps 31-100amps 101-200amps
A/C Circuits: —�0-60amps 61-100amps
Heat Circuits: 2 # circuits Q kw
Number of Lighting Outlets, Including Fixtures: _
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors4i Qty ❑Transformers KVA ❑Motorshp
FIRE ALARM SYSTEM (Requires 3 sets of plans&Fire Akrm Checklist)
Qty_volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG
❑Other.
Pemdt 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 coma 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 my other state or local law regulation construction or the performance of
con9Wcuon. 41
Electrical
Properly Owners Name �o t n 2�e_ Phone Number 4 L 3. 41
Electrical Company un; e c L - 6a o Jap Office Phone '-131- 4 21� Fax?31 -53
Co.Address: 5116 51- Avjvj ,%, 2City Sti w State�Zip321o7
License Holder(Print): N i C a e /. 1441 o State Certification/Registration# 6 Ll 3 0 5363
Notarized Signature ofLieense Flouter
9�nrw+nseVeruw.Frawewrp �4
Sworn and subscribed before me this 15 day of a o..dtr 2016
P per• ?RliNl:".K.GRIFFIN`
n.romusc:ou
Signature of Notary Public n7�