395 12th St elec pool permit jrlrylJr�
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
]OB INFORMATION:
Job ID: 16-ELEC-2748
Job Type: ELECTRIC ONLY
Description: ELECTRIC - POOL
Estimated Value:
Issue Date: 12/9/2016
Expiration Date: 6/7/2017
PROPERTY ADDRESS:
Address: 395 12TH ST
RE Number: 171922-0000
GENERAL CONTRACTOR INFORMATION:
Name: HAZOURI ELECTRIC, INC.
, EC0000379
Address: P O BOX 56559 QA ROBERT HAZOURI
Phone: -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Swimming Pools $40.00
Trade Permit Base Fee $55.00
Total Payments: $99.00
PERMTT 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 I /
CLC--C-Z748r�) ^ h Ph(904)247-5826 Fax(904)247-5845 la
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JOB ADDRESS: _9 I ds j�— PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS _PHASE
VALUE OF WORK S
NEW SERVICE ❑ Overhead ❑ Underground ❑i Underground up Pole
DReaidential(Main)Service
DO-100amps D101-150amps ❑151-200amps LJ amps #of Meters
DCommercial(Main)Service
00-100 amps D101-150amps 0151-200amps []--------amps OCTServiceamps
Conductor Type Sin
❑Multi-Family(Main)Service
00-100 amps 0101-150amps D151-200amps Clamps #of Unit Meters
❑Temporary Pole amps
SERVICE UPGRADE Damps 0 CT Service_amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
D 100 amps D 150amps 11200amps 0 amps DCT Service_amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Oudets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps _31-100amps _101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits Qkw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool OSign ❑Smoke Detectors_Qty ❑Transformers KVA DMotors_bp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORKS
REPAIRSIMISCELLANEOUS
❑Replace Burnt/Damaged Poo
CO
Can DSafety Inspection Panel Change OOH to UG
DOther: Po 1 W 1r-c
Permit hecemes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby cantly,that 1 have
read this appliwlim and know the same w be tme and COrrent. 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 any other state or local law regulation consWction or the performance of
wustruction. 1�
Property Owners Name R�' A� 1�6N(CJ2� PhoneNumber
Electrical Company_ cu�L 0 `t r', Lr �` Office Phone�S�
Co.Address: City State Zip
,� Zolrw [C'
License Holder(Print): 0/ C✓l State L' � cation/Registration C < 0000 ?7�
Notarized Signature o Lkense Holder
.p. TOM OIa01ESPERGER
WccW1SSIoarFF9M1 afore Is cM. 2
EXPIRES:Octobe 6,2019
e,waTnmraarwucuwnmen ignature of Notary Public