239 Beach Ave elec permit CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
'L ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
]OB INFORMATION:
Job ID: 17-ELEC-3357
Job Type: ELECTRIC ONLY
Description: ELECTRIC - 18 FIXTURES
Estimated Value:
Issue Date: 2/27/2017
Expiration Date: 8/26/2017
PROPERTY ADDRESS:
Address: 239 BEACH AVE
RE Number: 170190-0000
PROPERTY OWNER:
Name: HYMAN, CHARLES D AND JANET S, `
Address: 239 BEACH AVE
GENERAL CONTRACTOR INFORMATION:
Name: LORE ELECTRICAL CONTRACTORS
Michael Lee Lore, EC13006692
Address: 210 N ROSCOE BLVD QA MICHAEL LEE LORE
Phone: -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Lighting Outlets, Including $10.80
Fixtures
Trade Permit Base Fee $55.00
Total Payments: $69.80
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION G �N( L \yl..
32233
CITY OF ATLANTIC BEACH Q C/VU- i
9 / 800 Seminole Rd, Atlantic Beach,FL 7
JOB ADDRESS:_Z 3 / 6'l 247-5826 Fax(904)247-5845 ) '7
7 PE��c- 3'Js /
JEA INFORMATION REQUIRED ON ALL PERMII•'TSS qC'a AMPS W& VOLTS / PHASE
VALUE OF WORK$ tl"
NEW SERVICE ❑ Overhead ❑ Underground 0 Underground up Pole
❑Residential(Main)Service
00-100 amps ❑101-150amps ❑151-200amps []------amps #of Meters
❑Commercial(Main)Service
❑0-100 amps ❑101-150amps 0151-200amps ❑ amps ❑CTServiceamps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
[]Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service maps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps ❑ amps ❑CT 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: /y
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 WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can 0 Safety Inspection ❑Panel Change OOH 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 certifpthat I have
read this application and know the same w be tore 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 my other stare or local law regulation construction or the performance of
construction.
Properly Owners Name// / 'h-i17'! Phone Number
Electrical Company ! eras/-� U7t.7/-t, Office Phone A l-L/y Fax 3 —Y01P
Co.Address: J'GBt:B! City p1113,4. State?/. Zip .32-r2-
License Holder (Print): f 42 State Certification/Registration#60LO-e/30-Zk
Notarized Signature of L' older
mNIG1l ji EFGEa
= MY co wISSION 0 FF 924951 Before me this Z7 day o 20
r 19
EXPIPES
1,0.d -n ,PUDkantl ar.A
a Signature of Notary Public