350 3RD ST - ELECTRIC GUEST HOUSE tr.:
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`.1' iii \�� CITY OF ATLANTIC BEACH
„ - . „ s� 800 SEMINOLE ROAD
- 7-"X ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-ELEC-3679
Job Type: ELECTRIC ONLY
Description: new electrical service to guest house
Estimated Value:
Issue Date: 4/5/2017
Expiration Date: 10/2/2017
PROPERTY ADDRESS:
Address: 350 3RD ST
RE Number: 169784-0000
PROPERTY OWNER:
Name: Henderson, Jacqueline
Address: 350 3Rd ST
GENERAL CONTRACTOR INFORMATION:
Name: KNIGHT ELECTRIC LLC
, ER13012523
Address: 908 S 11TH AVE QA MARK STEVEN KNIGHT
Phone: - -
FEES:
New Single Family Electrical $50.00
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $109.00
II
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Ji r ',j,' , ATLANTIC BEACH
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PERMIT RECEIPT
\4.01119''::,--- ......... ) April 5, 2017
PERMIT DESCRIPTION: new electrical service to guest house
PERMIT NUMBER: 17-ELEC-3679
ADDRESS: 350 3RD ST
CITY OF ATLANTIC BEACH
OWNER: 800 SEMINOLE RD
ATLANTIC BEAC,FL 32233
New Single Family Electrical $50.00 04 05.2017 10:26:44
CREDIT CARD
State Elec DBPR Surcharge $2.00 VISA SALE
CARD» XXXXXXXXXXXX6036
State Elec DCA Surcharge $2.00 INVOICE 0002
SEQ R: 0002
Batch u: 000533
Trade Permit Base Fee $55.00 Approval Code: 092650
Entry Method: Manual
Mode: Only
Tax Amount: $0.00
Totals: Card Code: M
$109.00
SALE AMOUNT $109,00
CUSTOMER COPY
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tA..W't'RICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233 ,
Ph(904) 247-5826 Fax(904)247-5845 I/+—aL� t cI— 1co
JOB ADDRESS: 0 . . S 7 PERMIT# (7-31
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑J Underground up Pole
7Residential (Main) Service
u 0-100 amps L i 101-150amps i i 151-200amps amps #of Meters
I..iCommercial(Main)Service
00-100 amps I i 10l-1 SOamps fl 151-200amps L amps 7_1CT Service amps
Conductor Type Size
,_i Multi-Family(Main)Service
iJO-100 amps ":101-150amps ..:151-200amps I amps #of Unit Meters
:Temporary Pole u amps
SERVICE UPGRADE r1 amps CT Service amps
NEW 1FEEJ1ER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
1400 amps n 150amps iJ200amps amps I ICT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-3 Damps 31-100amps 101-200am ps
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 C Sign Ti Smoke Detectors_Qty E Transformers KVA :Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
Replace Burnt/Damaged Meter Can 'Safety Inspection i.JPanel Change DOH to UG
l Other: 0Ife.S1— '-6:'-
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 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.
Property Owners Name ?C4VJ Sc(�I&v� Phone Number
p� S
Electrical Company tivi(111 Et-t'C 42. (,.LC- Office Phone Fax
Co.Address: 9 D i( k J_ City 1A-- {k State r, Zip 3 �
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License Holder(Print): `4-' r fiXt- State Certification/Registration# 51(10/2.5/2
Notarized Signature of License Holder Y
it.
Trngyklo J P 1INn Sworn and subscribed before me this • . . �►; 1 20 4-
r 1 NOTARY PUBLIC
STATE OF FLORIOA Signature of Notary Public
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Expires 11/12/2017