447 Atlantic Blvd elec permit .j ylilrl ;
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
U
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-3126
Job Type: ELECTRIC ONLY
Description: ELECTRIC -ADD 2 GFI PLUGS
Estimated Value:
Issue Date: 1/27/2017
Expiration Date: 7/26/2017
PROPERTY ADDRESS:
Address: 447 ATLANTIC BLVD
RE Number: 170692-0500
PROPERTY OWNER:
Name: LYON ET AL, JONATHAN R
Address: 447 ATLANTIC BLVD SUITE 3 POPP MARK A 8,
GRIMSHAW RICHARD
GENERAL CONTRACTOR INFORMATION:
Name: H D LONG ELECTRICAL CONTRACTOR, IN
HARRY DANIEL LONG JR,EC0000726
Address: 1618 HAMMOND BLVD JACKSONVILLE, FLORIDA
32247-5788
Phone: 904-662-0292
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Switch Outlets $1.80
Trade Permit Base Fee $55.00
Total Payments: $60.80
PERMIT IS APPROVED ONLY W ACCORDANCE WITH ALL CITY OF ATLANTIC REACH ORDINANCES AND THE FLORIDA
RVILDDVG CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233 �� , _ 3176
y1 Ph(904)247-5826 Fax(904)24 -5845
JOB ADDRESS: /[ TL A NT I L I J AlD PERMIT#
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INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORE J
NEW SERVICE ❑ Overhead ❑ Underground D Underground up Pole
❑Residential(Main)Service #of Meters
❑0-100
in
D101-150amps ❑151-200amps ❑ amps
❑Commercial(Main)Service ams ❑CT Service_amPs
❑0-100 amps ❑101-150amps ❑151-200amps ❑ P
Conductor Type See
[]Multi-Family(Main)Service
❑0-100 amps 13101-150amps ❑151-200amps ❑ amps #of Unit Meters_
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service---amps
NEW FEEDER(ADIHTIONS,ACCESSORY STRUCTURESS,,IETC•) DCT Service_amps
❑100 amps ❑150amps ❑200amps ❑ P
REPAIRS,BUH.D-OUT
ADDTfIONS,REMODELS, S,ACCESSORY STRUCTURES,2 C.
Tamps
OutleWSwitches: L 0-30amps 31- 00amps
0-30am s 11-100amps 101-200amps
Appliances: P 61-100am
A/C Circuits: 0-60amsps kw P
Heat Circuits: # circuits (a�
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS ❑Transformers KVA ❑Motors_hP
❑Swimming pool ❑ Sign []Smoke Detectors_Qty
FIRE ALARM SYSTEM (Requires 3 sets of plans) VALUE OF WORK S
Qty_volts/amps
RFpAIRS/MISCELLANEOUS ❑Panel Change ❑OH to UG
❑Replace BumUDamaged Meter Can ❑Safety Inspection
Other: 6 E X [hall have
permit becomes void ifwork does not commence within a sin month period or work is suspended or abmdoed for six months. 1 ovming tbi,work will be warPl 0d with
be so,and correct. All provisions of ws and
ce
o,ad
icei N�noLnTh perm,[does no�m authority m violate the Provisions of and y other stamrdno!o�law regalmion emsaw don or the perfarmanee f
conaavction.
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propertyOwersNameO , Or
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Electrical Company �. �• L'O-N 1,5 - Com/ _' ",y✓none —�—
X31 ird city�_R�_----
FL zip 3222 f
Co.Address: feta ,� •,•l n state ��0060 Zzb
License Holder(Print):
. S on/Registration
#
Notarized Signature of License Holder day of 20L'1
Swom an of re me 's ucl {pl8d a --
Signature of Notary Public cesM ge tsMta
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