193 BEACH AVE #4 - ELECTRIC 1:-\1`r
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CITY OF ATLANTIC BEACH
�= __ 800 SEMINOLE ROAD
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ATLANTIC BEACH, FL 32233
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INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-ELEC-3718
Job Type: ELECTRIC ONLY
Description: ELECTRIC - 2 SWITCHES
Estimated Value: $500.00
Issue Date: 4/10/2017
Expiration Date: 10/7/2017
PROPERTY ADDRESS:
Address: 193 BEACH AVE 4
RE Number: None
PROPERTY OWNER:
Name: Travis, Russell L
Address:
GENERAL CONTRACTOR INFORMATION:
Name: JAGUAR ELECTRIC
, EC0002219
Address: P 0 BOX 7748 QA LOUIS ELLERY HOWARD
Phone: - -_
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Switch Outlets $1.20
Trade Permit Base Fee $55.00
Total Payments: $60.20
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
• 800 Seminole Rd, Atlantic Beach, FL 32233 7 n
• Ph (904)247-5826 Fax (904) 247-5845 v La 7"'3 18
JOB ADDRESS: C �- '! jPERMIT# /7} —3
JEA INFORMATION REQUIRED ON ALL PERMITS S AMPS jaO/W)VOLTS I PHASE
VALUE OF WORK$ 560 . o--
NEW SERVICE ❑ Overhead ❑ Underground nl Underground up Pole
CResidential(Main)Service
_0-100 amps H 101-150amps L1151-200amps amps #of Meters
1.1Commercial(Main)Service
L0-100 amps 0101-150amps U151-200amps _amps UCT Service_ amps
•
Conductor Type Size
C.-,Multi-Family(Main)Service
C:0-100 amps U 101-150amps L 151-200amps A amps #of Unit Meters
(Temporary Pole Cl amps
SERVICE UPGRADE 1.1 amps LI CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
I i100 amps U 150amps t 200amps 1 amps 1 ICT Service amps
ADDITIONS,REMODEL REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 1 0-30amps 31-100amps 10l-200amps
11 1 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 Li Sign Cl Smoke Detectors_Qty UTransformers KVA .1Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
l • REPAIRS/MISCELLANEOUS
UReplace Burnt/Damaged Meter Can 0Safety Inspection ;Panel Change LOH to UG
El 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 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 l")S,.5 e__
1, I ( f---0..v(-S Phone Number
Electrical Company 7f3&Le/fr^ &lL—C7j`,e / 2i C• Office Phone ,...50r'41673 Fax j -S'S- 7
Co.Address: 40..37 C/I)) 9;L/kt ,A4, 5 City ,�i9--- State P' Zip 3 L
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License Holder(Print): � i 5 1�13-r _.� tate Certificatio ; 'egistration# OOO 2-P1 S
Ail .1111.1
Notarized Signature of License Holder '
— — — — Before me this l 0 day of �/jF(Fri l 20 17
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ciP ��,= MARGARET M.MANAHAN ► Signature of Notary Public
.� _ Notary Public-State of Florida
9, _" 2 Commission#FF 244026 i
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