751 ATLANTIC BLVD - ELECTRIC FOR A/C j'\,,J\
, ,,
�' '' � , CITY OF ATLANTIC BEACH
r' ''" w 800 SEMINOLE ROAD
, ;r ATLANTIC BEACH, FL 32233
\ INSPECTION PHONE LINE 247-5814
'-4 J3ilc1-
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-ELEC-3663
Job Type: ELECTRIC ONLY
Description: ELECTRIC - DISCONNECT AND RECONNECT ROOF
TOP A/C UNITS
Estimated Value:
Issue Date: 4/3/2017
Expiration Date: 9/30/20.17
PROPERTY ADDRESS:
Address: 751 ATLANTIC BLVD
RE Number: 177645-0000
PROPERTY OWNER:
Name: OUR PROPERTIES INC
Address: P O BOX 330108
GENERAL CONTRACTOR INFORMATION:
Name: AMERICAN ELECTRICAL CONTRACTOR
Earl W. Frick, EC13007311
Address: 5065 ST AUGUSTINE RD APT 13 QA EARL W. FRICK
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Electrical Repairs $70.00
Work W/O Permit Electrical $110.00
Trade Permit Base Fee $55.00
Total Payments: $239.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
•
0ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904)/247-5845 1 ( _ EL EC. 3(0 6 3
JOB ADDRESS: /5 Al/C/4�/ ._ /0 ci PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 443 AMPS ..P�C.) VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead n Underground f v Underground up Pole
i;Residential(Main)Service
U 0-100 amps 101-150amps 151-200amps U amps #of Meters
:Commercial(Main)Service
'J0-100 amps 1101-150amps 1151-200amps C amps t!CT Service amps
Conductor Type Size
JMulti-Family(Main)Service
110-100 amps ❑10l-150amps ,151-200amps IT amps #of Unit Meters
['Temporary Pole 1 amps
SERVICE UPGRADE C amps CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
C 100 amps C l5Oamps C!200amps I, amps ilJCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES, ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100atnps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
}Swimming Pool C: Sign (_'Smoke Detectors Qty i_iTransformers KVA -:Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
_Replace Burnt/Damaged Meter Can ilSafety Inspection [!Panel Change ��I SOH to UG
[Other: '----)t,(_)601-.)n d- le (L:1)1)'C _5 liZc :'1"wl Cf) 4 ___
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 he 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. (0►71ey4rzd C'h014,1�
Property Owners Name ° a �/PJ . ., Phone Number )e/- ✓7/ /` O
Electrical Compa i AMP i/ , �.'C`�ria..._/ Office Phone h y'737-77.2Q Fax
Co.Address O /S i • ' 6 it/ City& J{ State1 Zipr13% 7
License Holder (Print): _,, / ` State Certifica • n/R i . atio �d-/,/,_. X:1573 ii
Notarize, . '!n,. •: , :)icenseHolder r et__ 4-(3 ce-1`� _jei4,
i t < NOTARY PUBLIC
:l F . t-STATE OF FLORIDA Sworn and subscribed be fore m this 3 I . of _ 4 r i 2017
% „.4' ,: Como*GG068924
Expires 21212021 Signature of Notary Publi ! ,VAA.kt AV ��/j
dr
CITY OF ATLANTIC BEACH
800 SEM INOLE ROAD CITY OF ATLANTIC BEACH
ATLANTIC BEACH, FL 32233 800 SEMINOLE RD
PHONE (404) 247-5825 ATLANTIC BEAC,FL 32233
Cashier Id: atlbcld\atlbbja 04,03;2017 16:38:10
Receipt Date: 4/3/2017 4:38:43 PM CREDIT CARD
Receipt Number: 0S-72785
MC SALE
Job ID: 17-ELEC-3663 - ELECTRIC - DISCONNEC
T AND RECONNECT ROOF TOP A/C UNITS EDBPR Card XXXXXXXX)(XXX1182
State Elec DBPR Surcharge $2.00 SEQ;t: 9
Job ID: 17 ELEC 3553 ELECTRIC - DISCONNEC 33+
T AND RECONNECT ROOF TOP A/C UNITS EDCA - S INVOICE 9
tate Elec DCA Surcharge $2.00 Approval Code: 075656
Job ID: 17-ELEC-3663 - ELECTRIC - DISCONNEC Entry Method: Manual
T AND RECONNECT ROOF TOP A/C UNITS EL18 - E Mode: Online
Iectrical Repairs $70.00
Tax Amount: $0.00
Cust Code:
JTo ANDb D RECONNECT ROOF TOPLA/CRIC -UNITSDEWC-NWORd M
K W/0 PERMIT ELECTRIC $110.00
Job ID: 17-ELEC-3653 - ELECTRIC - DISCONNEC SALE AMOUNT $239,00
T AND RECONNECT ROOF TOP A/C UNITS TP - Tra
de Permit Base Fee $55.00
Amount Due: $239.00
Tender Information: Cash $239.00
Tender Type: CC CUSTOMER COPY
Tender Amount: $239.00
Change Due: $0.00