381 4TH ST - ELECTRIC PANEL CHANGE . ?S LAPPlyt,
6s '` CITY OF ATLANTIC BEACH
Ali > 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
�;37�� INSPECTION PHONE LINE 247-5814
ELECTRICAL RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ERES17-0030
Description: panel change
Estimated Value: 1250
Issue Date: 5/30/2017
Expiration Date: 11/26/2017
PROPERTY ADDRESS:
Address: 381 4TH ST
RE Number: 169846 0000
PROPERTY OWNER:
Name: BARTLESON PATRICIA H
Address: 381 4TH ST
ATLANTIC BEACH, FL 32233-5343
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: VALDAN ELECTRIC CO.
Address: 338 19TH ST QA DANIEL J GWIZDAK
ATLANTIC BEACH, FL 32233
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 Commencement 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$7,500.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph/ (904)247-5826 Fax (904)247-5845 6,7_,L SI 9 -O(730
JOB ADDRESS: 3d/ 9'1,/ sT PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS /S<-' AMPS , VOLTS / PHASE
VALUE OF WORK$/,%" —
NEW SERVICE Er Overhead n Underground IJ Underground up Pole
❑Residential(Main)Segice
00-100 amps PIO1-150amps 0151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
00-100 amps 0101-150amps ❑151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
UMulti-Family(Main)Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
❑Temporary Pole 0 amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100 amps 0150amps 0200amps ❑ amps OCT 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 Cl Sign ❑Smoke Detectors_Qty ❑Transformers KVA ' Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans) /
Qty volts/amps VALUE OF WORK Sl4�J
REPAIRS/MISCELLANEOUS
UReplace Burnt/Damaged Meter Can U Safety Inspectionanel Change OOH to UG
❑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 Name1418/G A !7, �I fLti�SOY) Phone Number 47g''K, . I c 32/
Electrical CompanyqVALO A) EGEL7' /e- /AX' Office Phone Fax
Co.Address:jYJ /f1. (SIL Ø4SI C JN ft. City /�'T� Stater Zip 347-33
License Holder(Print): DIPI -- 6 Dvf 2d1L. State Certification/Registration#14:8 l'12'670
Notarized Si, 1 __,r -, older P /�3
JENNIFERJOFINSTON
. ,; MY COMMISSION S GG042964Before me this 3 O day ofd'�( 20,et.I.::';\
+ EXPIRES.October 27,2020
°` Note Public UndenYnters in ,&A.4),:gA6
;Foo Bonded n Signature of Notary Public
i•