178 BEACH DR - ELECTRIC c # \S, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
0.21
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-ELEC-3251
Job Type: ELECTRIC ONLY
Description: ELECTRIC - REMOVE METER FROM DUPLEX TO
SINGLE FAMILY
Estimated Value: $250.00
Issue Date: 2/13/2017
Expiration Date: 8/12/2017
PROPERTY ADDRESS:
Address: 178 BEACH AVE
RE Number: 170210-0000
PROPERTY OWNER:
Name: 178 BEACH AVE LLC
Address: 6 E BAY ST SUITE 500
GENERAL CONTRACTOR INFORMATION:
Name: NGUYEN ELECTRIC CONTRACTOR, LLC
Viet Nguyen, EC13007395
Address: 1602 Lockend RD
Phone: 904-612-9135
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845 � 7 'E �' — 3-1 51
JOB ADDRESS: / 7 fea..4 4 v PERMIT#
O°
JEA INFORMATION REQUIRED ON ALL PERMITS 2 AMPS%2#? VOLTS ` , -- --* PHASE
oc•
VALUE OF WORK 5
NEW SERVICE ❑ Overhead ❑ Underground U1 Underground up Pole
❑Residential(Main) Service
00-100 amps 0101-150amps 0151-200amps 0 amps #of Meters
[Commercial(Main)Service
❑0-100 amps 0101-150amps 0151-200amps 0 amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps 0101-150amps 151-200amps 0 amps #of Unit Meters
❑Temporary Pole 0 amps
SERVICE UPGRADE U amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100 amps 0 150amps 0200amps 0 amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-I00amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
I]Swimming Pool 0 Sign [Smoke Detectors Qty Transformers KVA (Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
C)Replace Burnt/Damaged Meter Can Safety Inspection t
�0Panel Change OOH to U
GlOther: 2ot.ib 4,42 vM. c" 2- �4 5'11 II LA—it
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 / 71 fe,..4 Z.Z Phone Number
Electrical Compy - / _ LAG C C Office Phone��7_' %Fax
Co.Address: l Le Cityr State/--L Zip 2
License Holder(Print): !t,- 7L State Certification/Registration#
Notarized Signature of License Holder ea" Apt ..._—
Before
me this / 3 d y of 7C4144-2,24..,. 2 0.Y 7
y 2° RA D.KOZEE
Signature of Notary Public . , , ,, M1'COMMISSION f FF 941988
L. '. ,_XPIRES:January 22,2020
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