1842 Mayport Rd elec safety permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
70B INFORMATION:
Job ID: 17-ELEC-3301
Job Type: ELECTRIC ONLY
Description: ELECTRIC - SAFETY OWNER WILL MARK AND
LOCATE ADDRESS
Estimated Value: $200.00
Issue Date: 2/2112017
Expiration Date: 8/20/2017
PROPERTY ADDRESS:
Address: 1842 MAYPORT RD
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: VALDAN ELECTRIC CO.
,EC13002670
Address: 338 19TH ST QA DANIEL J GWIZDAK
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 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
/11/ Ph(904)247--558826 Fax(9044' 24 -5845 17-ELEC _33 O `
JOB ADDRESS: r{'� ��()l� /\ PERMrr#
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS . --VOLTS 3 PHASE
I-L"
VALUE OF WORK J
NEW SERVICE ❑ Overhead ❑ Underground ❑I Underground up Pole
❑Residential(Main)Service
00-100 amps E1101-150amps 0151-200amps Damps #of Meters
❑Commercial(Main)Service
00-100 amps 0101-150amps 0151-200amps ❑ amps OCT Service amps
Conductor Type Sim
❑Multi-Family(Main)Service
00-100 amps ❑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 11200amps ❑ 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 ❑Motorshp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORKI
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can , afety Inspection ❑Panel Change ❑OH to UG
❑Other:
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 Kveming 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. y- �1 ' /y��/ y�
Property Owners Name �Lo I GZG GIW�/Q Phone cN/umber 707 . 7 7 'S3��
Electrical Company 1 14 L(X�JAl 7/ L (NC/ Office Phoh2! ` 7/6 ;426
,/) ) q 1`11 �--_ City&State, L Zip LZ T3
Co.Address:_ _ ��''
License Holder(Print): JA/Ik L G '"rtz-'� k— State Certification/Regist�tion#3 OVZ4 7 O
Not - IAer
YpY^ woo"MNOLeEVaPEPGFIF924851 _
- expiaes:snorers,", efore me this day of 0�`�
aoa4ETAn&O PUNrn Xlgn
Signature of Notary Public