306 12th St elec permit ALCITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
IV INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEI(T DAY INSPECTION: 247-5814
30B INFORMATION:
Job ID: 16-ELEC-2829
Job Type: ELECTRIC ONLY
Description: add 6 outlets/switches, 12 lighting outlets
Estimated value:
Issue Date: 12/19/2016
Expiration Date: 6/17/2017
PROPERTY ADDRESS:
Address: 306 12TH ST
RE Number: 171923-0000
PROPERTY OWNER:
Name: TOUSEY JR, CLAY B & PHYLLIS,
Ad-dress: 2225 ALICIA LN
GENERAL CONTRACTOR INFORMATION:
Name: LORE ELECTRICAL CONTRACTORS
Michael Lee Lore,EC13006692
Address: 21ONROSCOEBLVD QA MICHAEL LEE LORE
Phone:
FEES:
Lighting Outlets, Including $7.20
Fixtures
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Switch Outlets $3.60
Trade Permit Base Fee $55.00
Total Payments: $69.80
PERMIT IS APPRO�D ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODE&
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
Ph(9 247-5826 Fax (904)247-5845 1 EL LL-a ew�;C)
JOB ADDRESS: 3o 2 PERIVITI!#
VA INFORMATION REQUIRED ON ALL PERMITS 200 AMPS ZqOVOLTS PHASE
VALUEOFWORKS
NEW SERVICE El Overhead Underground D Underground up Pole
DResidential(Main)Service
00-100amps D101-150ampes 0 151-200mps I I amps 9 of Meters
OCommercial(Main)Semi"
00-100 mpg D101-150amps 0 151-200amps C___,__amps UCTServicearips
Ceinductor Type sin
DMulti-Family(Main)Semice
00-100 amps D101-150amps 0 1 51-200amps Ll_amps 4 of Unit Meters
OTemporary Pole D—MPS
SERVICE UPGRADE 0 mpg 0 CT Service_mpg
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100amps 0150amps 11200amps D amps [ICTServicemps
ADDITIONS,REMODEItS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: _�e_0-30amps 31.100amps —101-200amps
Appliances: _____9-30amps 31-100amps —101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
DSwimmingPool L Sign DSmokeDetectors_Qly D'Frainsformers KVA [3Motors_bp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty—volts/amps— VALUE OF WORK S
REPAIRS"SCELLANEOUS
[11teplace Buynt/Damaged Meter Cam OSafoty Inspection DPanel Change DOH to UG
DOther:
fount beconics void if work does not cornmence within a six month period or work is suspended or abandoned for six montles. I hereby catify that I have
r"A this application and know the.to be true and�.mecl. All provisions oflaws and ordinances governing this wort will be complied with whether
specified or not no pcmut dm not give authority to violate the provisions of my other son,or local law regulation construction or the pe,fiannearace of
construction.
property Owners Name 6 ust - Phone Nurnber
ElectricalComparry, L.4�- - A[40-( aJo4dd-� -OffimPhone 273— YO Fa;l32k?0/9'
Co.Address: �-( D 9 f1PE'q'f- 8(yip . City Swe'Z( Zip 8'2-
License Holder(Print): M._aodk Ld�� 'fication/Registration 0LO b 13 b
Notarized Signa lure of L icenNe Hold or
JENNTFERJOHNn�, this IC� dyof DtL W 20 tu
A Before me
MYCOMMISSIONOGG(W29M
UPIRES Dvober2r= Signature of Notary Public
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