1021 Atlantic Blvd elec permit 3 Vii.-Cllr rI
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
JOBINFORMATION:
Job ID: 17-ELEC-3485
Job Type: ELECTRIC ONLY
Description: safety- install temporary lights in tent
Estimated Value:
Issue Date: 3/14/2017
Expiration Date: 9/10/2017
PROPERTY ADDRESS:
Address: 1021 ATLANTIC BLVD
RE Number: 177602-0040
PROPERTY OWNER:
Name: EQUITY ONE ATLANTIC VILLAGE,
Address: 16 NE MIAMI GARDENS DR ATTN: TREASURY DEPT
GENERAL CONTRACTOR INFORMATION:
Name: SOUTHERN ATLANTIC ELECTRIC CO
Raymond Morris McIntosh, EC0001499
Address: 11618 E COLUMBIA PARK DR DANNY MCINTOSH
Phone: -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $59.00
PERMIT IS APPROVED ONLY M 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
JOB ADDRESS: 967 ATLANTIC BLVD., ATLANTIC BEACH,FL 32233 PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 200 AMPS 208 VOLTS 3 PHASE
VALUE OF WORK S
NEW SERVICE ❑ Overhead ❑ Underground ❑1 Underground up Pole
Residential(Maio)Service
0-100 amps 101-150amps 151-200amps _amps #of Meters
Commercial(Main)Service
0-100 amps 101-150amps 151-200amps amps CT Service amps
Conductor Type Size
Multi-Family(Main)Service
0-100 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 200amps _amps CT Service_amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-I00amps _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 Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK S
REPAIRSIMISCELLANEOUS
Replace Bumt/Damaged Meter Can Safety Inspection Panel Change OH to UG
x Other: Safety(install temp. lights in tent) Tent permit— 17-TENT-3464
Permit becomes void ifwork does not commence within a six month Mind 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 wish whether
specifwd 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
wnstruction.
Property Owners Name Michelle Culhane Phone Number 904-249-9595
Electrical Company Southern Atlantic Electric Co.. Inc. Office Phone 904-268-3009 Fax904-268-3899
Co. Address: 11618 Columbia Park Dr. East City Jacksonville State FL Zip 32258
License Holder(Print): Raymond M. M� State Certification/Registration#EC-0001499
Notarized Signature of License Holler ' --
UNDAV-NAVES
Notary Public Sum of Plaids Sworifand subscribed before m 3th day of March 2017
MV C,,,,Fapase Feb.12,2020 Signature of Notary Public
catlrriuion No.IF 96M2{