1165 Ocean Blvd elec permitCITY OF ATLANTIC BEACH
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:
17-ELEC-2909
Job Type:
ELECTRIC ONLY
Description:
remodel 16 outlets/switches 810 fixtures
Estimated Value:
$3,200.00
Issue Date:
1/3/2017
Expiration Date:
7/2/2017
PROPERTY ADDRESS:
Address:
1165 OCEAN BLVD
RE Number:
170276-0010
PROPERTY OWNER:
Name:
JASKIEWICZ , ADAM
Address:
913 SORRENTO RD 913 SORRENTO RD
GENERAL CONTRACTOR INFORMATION:
Name:
CURTIS DUVALL ELECTRIC
Curtis D. Duvall, EC13006278
Address:
281 HORSETAIL AVE CA BENJAMIN L HARRIS
rnvne -
FEES:
Lighting Outlets, Including $6.00
Fixtures
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Switch Outlets $9.60
Total Payments: $74.60
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
JOBADDRESS: /l () � �%i� 4 ZL4-C2 PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS a.0 AMPS �? o VOLTS I PHASE
NEW SERVICE ❑ Overhead ❑
❑Residential (Main) Service
00-I00amps 0101-150amps
❑Commercial (Main) Service
00-100 amps D101-150amps
Conductor Type Size _
OMulti-Family (Main) Service
00-100 amps 0101.150amps
[]Temporary Pole amps
SERVICE UPGRADE ❑_amps
VALUE OF WORKS 3.�,�)
Underground ❑7 Underground up Pole
O 151-200amps
0151-200amps
I1 amps
L amps
0151-200amps 0 amps
0 CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.)
0100amps ❑ISOamps 0200amps ❑ amps OCTService
# of Meters
OCT Service _ amps
# of Unit Meters
amps
ADDITIONS, REMODELS, REPAIRS, BUIL"UTS, ACCESSORY STRUCTURES, ETC
Outlets/Switches:
_,C,0-30amps
31-I00amps 101-200amps
Appliances:
0-30amps
31-100amps 101-200amps
A/C Circuits:
0-60amps
61-1 OOamps
Heat Circuits:
# circuits Q
kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑Sign OSmoke Detectom_Qty []Transformers EVA OMotors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty _ volts/amps VALUE OF WORK S
REPAIRSIMOCELLANEOUS
❑Replace Burnt/Damaged Meter Can OSafety Inspection ❑Panel Change OOH to UO
T
read this application and know the same to be true and correct. All provisions of lows and ordinances governing this work will be complied with whether
specified or nor The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of
conston,ion. _
Pmnercv ownere blame/7�F'a� S0.S'\i e< -✓1 CZ Phone Number
Electrical CompanyL�-r
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Office Phone /OI/6S�/Si 6R Fax
Co. Address: 2 $1
City State /'�-Z Zip 320
License Holder (Print): / /.r rr/[,f // ==Z State
Notarized Signature of License Holder 0�e`�
rR<�5: tENwrea Before me this 3
To' f
day of 0. nes W U 20 ( �
3+ 1 MY P1RES:altlNrna WNN rvT n.
FSPIPEa:IkbMrrr. a110 Signature of Notary Public
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