960 Sailfish Dr elec permit rj y11 Pj,
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
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-3753
.Job Type: ELECTRIC ONLY
Description: 100 amps/240 volts/single phase - change panel & install
water heater
Estimated Value:
Issue Date: 4/12/2017
Expiration Date: 10/9/2017
PROPERTY ADDRESS:
Address: 960 SAILFISH DR
RE Number: 171168-0000
PROPERTY OWNER:
Name: BURT, ARTHUR W
Address: 960 SAILFISH DR
GENERAL CONTRACTOR INFORMATION:
Name: AMERICAN ELECTRICAL CONTRACTOR
Earl W. Frick,EC13007311
Address: 5065 ST AUGUSTINE RD APT 13 QA EARL W. FRICK
Phone: -
FEES:
Electrical Appliances $2.00
Electrical Service Change $0.00
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $61.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845 �'{- E(_C_'3"}�3
V JOB ADDRESS: sa 1 1 C ISIS 'p'( PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 100 AMPS 01 0 VOLTS PHASE
VALUE OF WORK$
NEW SERVICEOverhead ❑ Underground D Underground up Pole
❑Residential ain)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps At of Meters
❑Commercial(Main)Service
LIO-100 amps ❑101-150amps F 151-200amps []—amps ❑CT Serviceamps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps 0101-150amps ❑151-200amps F amps #of Unit Meters
❑Temporary Pole ❑_amps
SERVICE UPGRADE [Iamps CT Service_amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps ❑200amps ❑_amps OCT Service_amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switchm: 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 ❑Transformers KVA ❑Motors_hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty_volts/amps VALUE OF WORK$
REPADIS/MISCELLANEOUS
❑Replace Bunt/Damaged Meter Can 7Safety Inspectionanel Change OOH to UG
DOther Aleve GAL koa hC,v
Permit becomes void if work does not ocen nence within a six month period orwork is suspended or abandoned fm six months. I hereby certify then I hove
m
read this application and know the sae to be ave and correct. All provisions oflaws and ordinances governing this work will be complied with whether
specified m nor The permit does not give authority to violate the provisions of any other state m local low reaulstion construction or the performance of
construction.
Propeny Owners Nam'ne tlrlt'ay� 1aP.l')" Phone NNu_mber Row3o3 ) 224
Electrical Company R�A6(a4b1e( "(C I COF14 Office Phone tt/My)'7�77aFax
Co.Address: OS— 2 ' y ]YL19 Stateja _Zap ZZOO
License Holder(Print): �� C St to CeRification/Registration#
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Notarized Signature Uicense Holder
n"IROTARY PUBLIC Sworn and and b fore me 's w day of n 20j/
o STATE OF FLORIDA
Lemma 000seaza
VSignature of Notary blit
Esplfea V212021
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ATLANTIC BEACH
PERMIT RECEIPT
r April 12, 2017
PERMIT DESCRIPTION: 100 amps/240 volts/single phase-change panel&install water heater
PERMIT NUMBER: 17-ELEC-3753
ADDRESS:960 SAILFISH DR
OWNER: CITY OF ATLANTIC BEACH
800 SEMINOLE RD
Electrical Appliances $2.00 ATLANTIC BEAC,R 3833
04122017 11,51:21
Electrical Service Change $0.00 CREDIT CARD
MC SALE
CARD: XXXV00X%%%%1482
State Elec DBPR Surcharge $2.00 INVOICE 0003
SEQ P: 0002
State ELec DCA Surcharge $2.00 Batch P, 000538
Approval Code: 319214
Entry KtW.. M3aa1
Trade Permit Base Fee $55.00 Mode: Oft
Tax Arrant: $BDO
Det Cade:
Cad Code: M
Totals: $61.00 SALE AMOUNT %I.M
CUSTOMER COPY
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