631 Beach Ave elec permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NE%T DAY INSPECTION: 247-5814
JOBINFORMATION:
Job ID: 16-ELEC-2872
Job Type: ELECTRIC ONLY
Description: ELECTRIC -4 SWITCHES
Estimated Value: $800.00
Issue Date: 12/27/2016
Expiration Date: 6/25/2017
PROPERTY ADDRESS:
Address: 631 BEACH AVE
RE Number: 170113-0000
PROPERTY OWNER:
Name: HUGHES, JAMES D
Address: 631 BEACH AVE
GENERAL CONTRACTOR INFORMATION:
Name: LORE ELECTRICAL CONTRACTORS
Michael Lee Lore, EC13006692
Address: 210 N ROSCOE BLVD QA MICHAEL LEE LORE
Phone: -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Switch Outlets $5.40
Trade Permit Base Fee $55.00
Total Payments: $64.40
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 / �--/�
/ 04)2247-5826 Fax(904)247-5845 16—E '287L
JOB ADDRESS: 631 b a- Ph(59a o t ,� PERMIT#
y
JEA INFORMATION REQUIRED ON ALL PERMITS J fy U AMPS 2%O VOLTS�_PHASE
VALUE OF WORK E_A?K2
NEW SERVICE ❑ Overhead ❑ Underground ❑I Underground up Pole
OResidential(Main)Service
00-100 amps 0101-150amps 0151-200amps U amps #of Meters_
❑Commercial(Maio)Service
00-100 amps 0101-150amps 0151-200amps U amps OCT Service _ amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑_amps #of Unit Meters_
❑Temporary Pole ❑_amps
SERVICE UPGRADE ❑_amps OCT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps O 150amps 0200amps ❑ amps ❑CT Service_amps
! ADDITIONS,REMODELS REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: :Wm�0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits Q kw
Number of Lighting Outlets, Including Fixtures:2
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detccmrs_Qty OTransformers EVA ❑Motors_hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty_volts/amps VALUE OF WORK S
REPADiS/MISCELLANEOUS
JReplace ButnttDamaged Meter Can ❑Safety Inspection ^.Panel Change OOH to UG
❑Other.
Permit becomes void if work does tool cammence within a six month period or work is suspended"abandoned for six months. I hereby certify that 1 have
read this application and know the.to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether
specified or not. ]-no permit does not give authority to violate the provisions ofany other state or local law regulation construction or the performance of
construction. 1
Property Owners Name /7�1��07� Phone Number
Electrical Company 4�0 lFC t cOtfioe Phone ZJ3-/1✓3 Fax 3 7J-fol-e
Co.Address: 2A Al /��1.rcob B//�ueO city PU!. state L/zip 31a8Z
License Holder(Print): /t% f� a tate Certification/Registration#Lx- Ia/3d Z�
Notarized Signature ojLicense Holder -7
=J�Ieyx=
AaEaBefore me thisz-! day 20
F925951r 8,2019 Signattue ofNotary Public
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