715 Atlantic Blvd #1 elec permit rf IyLJrI�� .
•>J 11�n CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
j s ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job To: 16-ELEC-2856
Job Type: ELECTRIC ONLY
Description: ELECTRIC - REPLACE BURNT DISCONNECT OUTSIDE
Estimated Value: $900.00
Issue Date: 12/22/2016
Expiration Date: 6/20/2017
PROPERTY ADDRESS:
Address: 715 ATLANTIC BLVD 01
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: DEPENDABLE ELECTRICAL
, ER13014338
Address: 2009 S JIMMY LN MUKESH T VARDE
Phone: -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Electrical Repairs $35.00
Trade Permit Base Fee $55.00
Total Payments: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845 -(—� LEC— z 8 S co
JOB ADDRESS: 6\yd PERMIT//
JEA INFORMATION REQUIRED ON ALL PERMITS X00 AMPS 2�B VOLTS PHASE
VALUEOFWORK$ 0.o0.00
NEW SERVICE ❑ Overhead ❑ Underground ❑I Underground up Pole
❑Residential(!Hain)Service
❑0-100 amps 0101-150ampS 0151-200amps f I _ _..amps N of Maters_
❑Commercial(Main)Service
00-100 amps 0101-150amps 0151-200amps O__ maps UCT Service_amps
Conductor Type Sin
OMulti-Family(Main)Service
00-100 amps 0101.150amps 0151-200amps 0_. amps B of Unit Meters_
I(Temporary Pole []_amps
SERVICE UPGRADE ❑ amps 0 CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100amps 0150amps 0200amps []_amps OCTService_amps
ADDITIONS,REMODELS,REPAIRS,BUH.D-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: H circuits Qkw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign OSmoke Detectors_Qty ❑Transformers KVA OMotors_bp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty voltstamps VALUE OF WORK$
REPAMSMSCELLANEOUS
OReplace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change OOH to UG
'�Odter. �p\coca �uvs.} 6s'�r_m-r cc9c o�SiA�
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six monNs. 1 hereby certify airi f have
read this application and know the same to be true Rod coned 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
construction.
Property Owners Name ��,A' F- Phone Number 010lA-qq1 - 0.\0.3
Electrical Company �a-��"xV\'` E\Qo-k�c°J r"+��t>,r-4^'S OfficePhonelk +-3?4->6y4 Fax
Co.Addm,: o'r's a»`e City " saelL%v-o1\ve State Fr- Zip 3'
License Holder(Print): State Certification/Registration k C-'esSo\4'x14
Notarized Signature of License Holder .W
Ws"U�001
Before me thisZ day of 20BFF824951bRr6,E919 Signal=of Notary Public uamuma.nan