366 SEMINOLE RD - ELECTRIC REPAIR �� �?� CITY OF ATLANTIC BEACH
ed� S 800 SEMINOLE ROAD
J� =" 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-3066
Job Type: ELECTRIC ONLY
Description: ELECTRIC - REPAIR MAST
Estimated Value:
Issue Date: 1/23/2017
Expiration Date: 7/22/2017
PROPERTY ADDRESS:
Address: 366 SEMINOLE RD
RE Number: 170427-0000
PROPERTY OWNER:
Name: ANDERSON, MARY K
Address: 366 SEMINOLE RD
GENERAL CONTRACTOR INFORMATION:
Name: CRAWFORD ELECTRIC
John Robert Crawford III, EC13002649
Address: P 0 BOX 51045 QA JOHN ROBERT CRAWFORD III
Phone: 904-241-5591
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233 LLC -
Ph(904) 247-5826 Fax(904)247-5845 J�
JOB ADDRESS: 34 //����C kkg PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead n Underground I Underground up Pole
❑Residential(Main) Service
00-100 amps ❑101-150amps l 151-200amps _i amps # of Meters
❑Commercial(Main)Service
00-100 amps ❑101-150amps ❑151-200amps 1 amps ICT Service amps
Conductor Type Size
[1 Multi-Family(Main)Service
1 0-100 amps ❑101-150amps ❑151-200amps ❑ amps # of Unit Meters
❑Tem porary Pole ❑ amps
SERVICE UPGRADE lI amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps ❑ amps 0 C Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-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: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors Qty Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
Replace Bumtt/�Damaged Meter Can ❑Safety Inspection ❑P.nel j;,:...==- : - -
ther: - `(.7 f 1 W ires or 1 `I E`Lz (o06 S
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have
read this application and know the same to be true and correct. 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 construction or the performance of
construction. rd
'
Property Owners Name r tl 4Ls -_ Phone Number
Electrical Company 44.4. 44.- Office Phone g(17-531 I Fax / ?c'3 7
Co.Address: 9312/ 110,751 (i.,../l(H-{/ If- City 1 17L & tate Fc Zip -- 22-6,‘%.
License Holder(Print): ,..f.../0)144A ,C. (; Card' State Certification/Registration# IfG ,A)G 4/7
Notarized Signature of License Holder
"efore me this day of o 46 w 0 r7 _
TONI GINDLESPERGER ".
E COMMISSION#IFF 92019 •i nature of NotaryPublic i `mIII
r...... EXPIRES:October 6,2019 g1
.. . it:nded Thtu Notary Public Underwriters