1755 Beach Ave elec permit �s CITY OF ATLANTIC BEACH
r 800 SEMINOLE ROAD
j ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
r1
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-ELEC-3068
Job Type: ELECTRIC ONLY
Description: NEW SERVICE - 200 AMPS, 240 VOLTS, SINGLE PHASE
Estimated Value:
Issue Date: 1/25/2017
Expiration Date: 7/24/2017
PROPERTY ADDRESS:
Address: 1755 BEACH AVE
RE Number: 169672-0000
PROPERTY OWNER:
Name: Swanson, Jeffrey D
Address: 1755 Beach AVE
GENERAL CONTRACTOR INFORMATION:
Name: TITAN ELECTRIC GROUP, INC.
,EC13003262
Address: 2730 -7 CL CLYDO RD QA CHARLES WILLIAM
BELINGHOFF
Phone: -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
New Single Family Electrical $70.00
Trade Permit Base Fee $55.00
Total Payments: $129.00
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
Ph(904)247-5826 Fax --r(904)247-5845 1 I — EJU--C --3 0 G S
JOB ADDRESS: {� PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS l/ VOLTS _PHASE
YALUEOFWORRJ
NEW SERVICE 0 Overhead Underground 0 Underground up Pole
1Residential(Main)Service �
DO-100amps 1:1101-ISOamps 111151-200amps ! !_amps 4ofMeters
1_
r!Commercial(Main)Service
t 10-100 amps L 101.150amps 11151-200amps IIemps I ICT Service_amps
Conductor Type_ Size
IMulti-Family(Main)&rvice
110-100 amps n101-150amps 1.1151-200amps Ii amps #of Unit Meters
UTemporary Pole(Lamps ---
SERVICE UPGRADE [.]-----_amps U CT Service_amps
NEW FJrE ER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
IF/I00tmps 0150amps D200amps Damps DCTService_amps
ADDITIONS,HE.MODE REPAIRS,BUH.D-OUTS,ACCESSORY STRUCTURES,ETC.
OutletsAppliance
-30amps 31-IOOamps _101-200amps
Appliances: 0-30amps _�31-100amps 101-200amps
A/C Circuits: 0-60amps 61•I00amps
Heat Circuits: #circuits @ kev
Number of Lighting Outlets, Including Fixturos: I?-
OTHER ELECTRICAL PROJECTS
OSwimming Pool ❑ Sign OSmoke Detectors_Qty OTransformers KVA DMolws_hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty_voluptuary; VALUE OFWOREJ
REPAIRS/MISCELLANEOUS
❑Replace Bumt/Damaged Meter Can [-'Safety Inspection Optimal Change DOH to UG
❑Other:
penal becomes void if work does not commence within a six month period or work is suspended car endoncd for six months. 1 hemby ratify that I have
read this application and know die same to be true and cored. All provisions oflaws and ordinances governing this work will be complied with whether
specifiedornort The permit does not give authority to violate the provisions ofany other state or local law regulation contraction or the perfomance of
cameuction. n far�R .r
Property Owners Name
` .���,.1 a�:���miN logt, Phone Number('1t/i�mt-
Electrical ComgpaafnlyflllL 'C�YRl1 GwG X( etQ�V� O Phone—S11.�F1ax��1[�, j7��'r'l
Co.Add=s: LThQ- tWbO D. city State�L ziPL
License Holder(Print): 4►Ai2.l1�s L (f $(ate on/Registration 01UM003263—
Notarized Signature of License Holder
Dori"A Ennis Sworn and subscribed before
NOTAPUBLIC methis-7—a d�ay^o
f � Ga.rkN 20�'I
STATE OF
FLORIDA Signature of Notary Public �M'•r1.�
Cannw FF985426
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