398 11th Street elec permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
w 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-3484
Job Type: ELECTRIC ONLY
Description: REPLACE THE EXISTINGMETER CAN / SERVICE
DISCONNECT WITH NEW
Estimated Value:
Issue Date: 3/14/2017
Expiration Date: 9/101201.7
PROPERTY ADDRESS:
Address: 398 11TH ST
RE Number: None
PROPERTY OWNER:
Name: FICKLING, ALAN
Address:
GENE RAL CONTRACTOR INFORMATION:
Name: SUMMIT ELECTRICAL CONTRACTORS
,E00001465
Address: 13790 RANCH RD QA HAROLD RICHARD HURST
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach,FL 32233
r7Ph(9044)247-5826 Fax(904)247-5845 7- E�EC--34-n 4
JOB ADDRESS: 3 q 1\*` S'tCmt PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS _200_AMPS _240_VOLTS _1_PHASE
VALUE OF WORT($
NEW SERVICE ❑ Overhead ❑ Underground D Underground up Pole
❑Residential(Main)Service
00-100 amps 0101-150amps 0151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
110-100 amps 6101-150amps ❑151-200amps ❑ amps OCT 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,BUQA-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: I 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
[:]SwimmingPool ❑ Sign []Smoke Detmtors_Qty ❑Transformers KVA ❑Motors_hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Bumt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG
❑Other: ftlace the existing meter can/service diswnnect with new `vact"0011LA0str/ni���
Permit becomes void if work does not commence within a six month period or work is suspende-440 fo liths. I hereby certify that I have
am
mad this application and know the se to be true and correct. All provisions of laws and ordir governing tlSµ_ 11 be complied with whether
specified or not The permit does not give authority to violate the provisions of any other state o3_$4s11ak7Cga�vtion�CnsAction or the performance of
construction. Z '.{ �aly�
Property Owners Name Alan Fickling Phone Number .......... `az
/t�rA7E pinNatO
Electrical Company Summit Electrical Contractors Inc. Office Phone 741-Q� Fax 741-0063
Co. Address: 13790 Ranch Rd City Jacksonville State Florida Zip 32218
License Holder(Print): Harold R. Hurst state Certifica n/Kegistration#EC0001465
Notarized Signature ofLimns7
Swom and subscribed before yme[his 131 il day of 20 7
Signature of Notary Public�SrfX 44:�