1545 Francis Ave elec permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
ELECTRICAL RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTI[ON: 247-5814
PERMIT INPORMA71ON:
PERMIT NO: 17-ELEC-3757
Description:
Estimated Value: 100
Issue Date: 5/17/2017
Expiration Date: 11/13/2017
PROPERTY ADDRESS:
Address: 1545 FRANCIS AVE
RE Number: 172284 ODOO
PROPERTY OWNER:
Name: Mary Jane Roys
Address: 1545 Francis AVE
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name: Walter William Gilliam
Address: 3061 North Phillips Highway Suite 101
Jacksonville, FL32207
Phone:
Name: Advanced Electric of North Florida Advan
Address: 3061 Philips HWY
JACKSONVILLE, FIL 32207
Phone;
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB
SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
*A notice of Coramencentent is only required for work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach,FL 32233
Ph(904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: rAvi c;c, Aue, PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS tQ)b AMPS j,'1 D VOLTS PHASE
VALUE OF WORK$
NEW SERVICE 0 Overhead E] Underground DUnderground up Pole
Residential(Main)Service
0-100 amps 101-150amps 151-200amps amps #of Meten
Commercial(Main)Service
0-100 amps 101-150amps 151-200amps —amps CT Service_amps
Conductor Type_ Sim
Multi-Famly(Main)Service
0-100 amps 101-150amps 151-200amps amps #of Unit Meters;
Temporary Pole amps
SERVICE UPGRADE amps CT Service_amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
100 amps 150aups 200amps amps �CT Service_amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: —0-30amps 31-100amps —101-200amps
Appliances: 0-30ampas 31-100amps _101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: #circuits
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— VALUEOFIVORK$ IM CC
REPAIRS/MISCELLANEOUS
Replace BumttDamaged Meter Can Safety Inspection Panel Change OH to UG
k,bth,: C �d
�(2S -P,5 ( A&
permit becurn.void ifuork does not coannumce veithi..sia inonth period or work is suspended or abandoned for six months. [hareltycanitytholle.
read this application and know the same to be ame sad correet. �,Il provisions oflanva and ordirancesgoveming this work will becomplied with whether
specifieclornot. The permit does not give authority to violate the provisions ofany other state or local law regulation construction or the perflarmance of
co.stmeflo..
Property Owners Name ilur, JAvt_ V2c !l s PhoneNumber
Electrical Company -OfficePhone 1�11_4"G Fax72Z-1V-1
Co.Address: (3661 IA-0105 81!�kwa� City rt, Zip3ZfZ-7
License Holder(Print): WA L7
_4L State Certification/RegistratiMiT9
Notarized Signature qf License Holder IAIIA A4�_�
Mas'b, BRITTAME GILBERT Sworn and subscribed before me this day of 190� 20Aj-
�.S WRY NbIle-Sl.u.j Florld Signature of Notary Public
MY Conan,Expifes Mar 2.20123
CO—Islion#FF 097114
Cash Register Receipt Receipt Number
City of Atlantic Beach R1572
0
DESCRIPTION ACCOUNT CITY PAID
PermitTRAK $64.00
---� " Z
17-ELEC-3757 Address: 1545 FRANCIS AVE APN: 172284 0000 $64�OO
00
AC Circuits R'l,
AC Circuflt� 'NONE'
State Elm CHSPR Surcharge $2.00
state Elec DBPR Surcharge
State Elec DCA Surcharge —7— $2.00
$2.00
State Elec DCA Surcharge IONE
Trade Permit flase Fee $55.00
Trade Permit Base Fee $qq'00
TOTAL FEES PAID BY RECEIPT: R1572 $64.00
Date Paid: Wednesday, May 17, 2017
Paid By:Advanced Electric of North Flo
Cashier: EA
Pay Method: CREDIT CARD 1
Printed:Wednesday,May 17,2017 8:34 AM 1 Of I It
ATOTIC BEKR
USEK"'RO
ATLXMCRkc,FL32233 R.3141
45J17J200 CREDIT CM
K SALE
WOMM4384
Old 4 1
SEQ#� 366
BO W i
ONOICE 224161
oval MWI
1 NY tktAd: On"
7111"
1'T L%
k
S
M
CRT
D
K
Old#
EQ#
ONOICE I"'
I
S
Woval Ct
6ty WtW
so I DO
1
6
6',
re
DO
Tat kwA
cad coo:
SA��Amour
sAa Amour
CUSTOM cop,
IL