1785 SELVA MARINA DR - ELECTRIC r S11
CITY OF ATLANTIC BEACH
f 800 SEMINOLE ROAD
J 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-3727
Job Type: ELECTRIC ONLY
Description: 200 amps/240 volts/single phase - relocate switch & lights
Estimated Value: $500.00
Issue Date: 4/11/2017
Expiration Date: 10/8/2017
PROPERTY ADDRESS:
Address: 1785 SELVA MARINA DR
RE Number: 172019-0000
PROPERTY OWNER:
Name: RODRIGUEZ, JASON
Address: 1785 SELVA MARINA DR
GENERAL CONTRACTOR INFORMATION:
Name: HWV MECHANICAL/ELECTRICAL CONTRACTORS
Christopher Hyman, ER13015213
Address: 12797 Wilderness LN
Phone: - -_
FEES:
Lighting Outlets. Including $1.20
Fixtures
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $60.20
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph (904)247-5826 Fax (904) 247-5845 1 -i ^ LLC- 3'4 a.4
JOB ADDRESS: 1785 Selva Marina Dr. Atlantic Beach, FL 32233 PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 200 AMPS 240 VOLTS Single PHASE
VALUE OF WORKS 500
NEW SERVICE ❑ Overhead ❑ Underground ❑J Underground up Pole
Residential(Main)Service
0-100 amps '101-150amps i 1151-200amps amps #of Meters
Commercial(Main)Service
0-100 amps :101-150amps 151-200amps amps Cr Service amps
Conductor Type Size
Multi-Family(Main)Service
0-100 amps 101-150amps 151-200amps amps #of Unit Meters
Temporary Pole i amps
SERVICE UPGRADE amps CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
100 amps 150amps 1200amps 1 amps ICT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
:Swimming Pool ' Sign ! Smoke Detectors_Qty i Transformers KVA Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
Replace Burnt/Damaged Meter Can i Safety Inspection Panel Change 01-I to UG
xOther: Relocate switch and lights. Also vanity lights.
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. (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 Jason Rodriguez Phone Number 9043388388
Electrical Company HWV Electrical and Mechanical Contractors,LLC Office Phone 9046474993 Fax
Co. Address: 9218 Cypress Green Dr. pity Jacksonvilles State FL zip 32256
License Holder(Print): Christopher Hyman State Certification/Registration# ER13015213
Notarized Signature of License Holder OP•A (P I 11.41(MA
Sworn and subscribed before me this 0'41 d of A.e i L 20 17
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4- 1'I MY COMMISSION#FF157183 Signature of Notary Public -
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^ 9 EXPIRES September 4,2018
(407;1a-0163 FloridallotaryService.com
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD CITY OF ATLANTIC BEACH
ATLANTIC BEACH, FL 32233 800 SEMINOLE RD
PHONE (904) 247-5825 ATLANTIC BEAC,FL 32233
Cashier Id: atlbcld\atlbbja 04(11;2017 08:16:09
Receipt Date: 411/2017 8:16:32 AM CREDIT CARD
Receipt Number: 0S-72864
Job ID: 17-ELEC-3727 - 200 amps/240 volts/s VISA SALE
ingle phase - relocate switch & lights EL8 Cad XXXXX)OWOU(X0218
- Lighting Outlets, Including Fixtures $1 SEQ 1
.20
Batch lc 340
Job ID: 17-ELEC-3727 - 200 amps/240 volts/s INVOICE
ingle phase - relocate switch & lights EDBP
R - State Elec DBPR Surcharge $2.00 Approval S 752946
Ely Method: Maul ID: 17-ELEC-3727 - 200 amps/240 volts/s MOde: On�ne
ingle phase - relocate switch & lights EDCA TaxAmount:
- State Elec DCA Surcharge $2.00 $0.00
Job ID: 17-ELEC-3727 - 200 amps/240 volts/s Card Code:
ingle phase - relocate switch & lights TP -
Trade Permit Base Fee $55.00 SALE AMOUNT 560,20
Amount Due: $60.20
Tender Information: Cash $60.20
Tender Type: CC
Tender Amount: $60.20 CUSTOMER COPY
Change Due: $0.00