860 Hibiscus St 16-ELEC-2811 New Elec Serv CITY OF ATLANTIC BEACH
'l 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
I �
ELECTRICAL PERMIT
MUST CALL BY 411M FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ELEC-2811
Job Type: ELECTRIC ONLY
Description: ELECTRIC - NEW SERVICE 200 AMPS, 240 VOLTS,
SINGLE PHASE
Estimated Value:
Issue Date: 12/15/2016
Expiration Date: 6/13/2017
PROPERTY ADDRESS:
Address: 860 HIBISCUS ST
RE Number: 170945-1020
PROPERTY OWNER:
Name: KSN INVESTMENT CORP
Address:
GENERAL CONTRACTOR INFORMATION:
Name: I Q POWER LLC
,CVC 56999 & EC 13004735
Address: 3983 St Johns PKWY
Phone:407-585-1018
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Trade Permit Base Fee $55.00
New Single Family Electrical $70.00
Total Payments: $129.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845
I
JOB ADDRESS: j{(o�) �� I � JG t.t_5 -E PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS aOC' AMPS 2.4 O VOLTS PHASE
VALUEOFWORK$
NEW SE$XICE Lf.S Overhead ❑ Underground E3 Underground up Pole
esidential(Main)Service
:..0-100 amps ,..::101-150amps i'151-200amps _ amps Nof Meters_
_Commercial(Main)Service
I.0-100amps :_101-150amps >1151-200amps _ amps CTService_amps
Conductor Type Site
Multi-Family(Main)Service
0-100 amps 7.tot-150amps _1151-200amps amps of Unit Meters_
'..]Temporary Pole L amps
SERVICE UPGRADE _ amps CT Service_amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
100amps '150amps f!200amps t:, amps -_':CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0.60amps 61-100amps
Heat Circuits: 4 circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
'a Swimming Pool JSign `.Smoke Detectors_Qty -!Transformers KVA C;Mutorshp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qtyvolts/amps VALUEOFWORK$I2elb
REPAIRS/MISCELLANEOUS
Replace Burnt/Damaged Meter Can Safety Inspection '_Panel Change -OH to UG
:Other:
Permit biomes void if wmk does not commence within a six month period or work is sm ended or abandoned for six months. I hereby certify that I have
read this application and know the same w be true and waect. All provisions of laws and ordinances gowourg this work will be complied with whether
specified m not The permit does not give authority to violate the provisions ofany other state or loml law regulation construction or the performance of
comnuceon.
Property OwnersName f 10.f YCF- C'-n Phone Number GIG y 9 y - N t4
Electrical Company C A Q POWL.( Office Phone/�0`F-Sfis-1018Fax 3.'11-.193--543z-
Co.Address:1183 SF SGhns cerKwo-� City Scen-tcref State FL zip 32.171
Ucense Holder(Print): —jh State Certification/Registration 962,,1 CO47Zi
.3-5
Notarized Signature of License Holder
Sworn and subscribeb fore me this /y dry};ofC 20 (�
MARIA PASTRANA
MY COMMISSION#FFMI62 Signature of Notary Public
EXPIRES May 23,2020
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