2393 OCEANS BREEZE CT - ELECTRIC - y\1�t
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s� \ CITY OF ATLANTIC BEACH
J800 SEMINOLE ROAD
\� �� -" ATLANTIC BEACH, FL 32233
\ INSPECTION PHONE LINE 247-5814
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ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-ELEC-3094
Job Type: ELECTRIC ONLY
Description: ELECTRIC - METER REPAIR
Estimated Value: $800.00
Issue Date: 1/25/2017
Expiration Date: 7/24/2017
PROPERTY ADDRESS:
Address: 2393 OCEAN BREEZE CT
RE Number: 168908-8230
PROPERTY OWNER:
Name: HANSEN, KIRK & BONNIE,
Address: 2393 OCEAN BREEZE CT
GENERAL CONTRACTOR INFORMATION:
Name: MATT VU ELECTRIC
, EC13001495
Address: 11639 ST JOSEPHS RD QA MATTHEW VAN VU
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 WITII 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 1'7 - ELEC - 3 09 4-
JOB ADDRESS: p2 3 9G,vtk rn te,--zJZ PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK$8 CO
NEW SERVICE D Overhead / Underground 1 Underground up Pole
❑Residential(Main)Service
00-100 amps ❑101-150amps ❑151-200amps amps # of Meters
❑Commercial(Main)Service
00-100 amps ❑101-150amps ❑151-200amps J amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main) Service
00-100 amps i 101-150amps ❑151-200amps ❑ amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps ❑ amps OCT 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 7Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK S
REPA S/MISCELLANEOUS
Replace Burnt/Damaged Meter Can ❑Safety,1nspection Ll Panel Change ❑OH to UG
❑Other: `nne4-Q f` lr P pa-4
C
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.
Property Owners Name (lb (11`{- klCkA4 QN Phone NumberZt ( �g0
Electrical Company 11/4A ATI V (A (,C CT A I C Office Phone PhonecOf ` g Sg0 f Fax16 97/ c20
Co.Address: 4 '70 1 000R \r it 'iir Civ0 restate PL Zip 3 7-2
License Holder(Print): 1 a- + ' ;�e Certi cation/Registration#t/3W i icc
Notarized Signatur' • • . ,. ,Ider t/ '&moWA'J
- TONI GINDLESPERGER 7
MY COMMISSION a FF 92495, t efore me this C.�S day o, a3l\.I ►0
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,ignature of Notary Public