2425 MAYPORT RD 17-ELEC-3117 SIGN HOOKUP ATLANTIC BEACH
PERMIT RECEIPT
I January 27, 2017
PERMIT DESCRIPTION: ELECTRIC FOR SIGN
PERMIT NUMBER: 17-ELEC-3117
ADDRESS: 2425 MAYPORT RD
OWNER: ANDREWS ENTERPRISES INC
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Electrical Sign $35.00
Trade Permit Base Fee $55.00
Totals:
$94.00
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ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: _2425 MAYPORT RD9 ATLANTIC BEACH,FL 32233 7 - E. -E,C -3 117
PERMIT##
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
❑Residential(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
00-100 amps ❑101-150amps ❑151-200amps [1amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 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 ❑150amps 0200amps ❑ amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-3 Damps 31-1 00amps 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 90Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$ 100- 00
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change OOH to UG
❑Other: 0x- yp </1l9 fa EY/s7-14y 6'rtce�"r5
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 Circle K Stores, Inc. -1401 Phone Number
Electrical Company KRG Electric,Inc. Office Phone 850=543-9217 Fax
Co.Address: 91 Norwood Dr 8 City Miramar Beach_State FL_Zip 32550
License Holder(Print): Kurt Gillett State Certification/Registration#EC 13006264
Notarized Signature of License Holder
Sworn and subscribed before me this / day of 20-L(,�v
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904)247-5845
JOB ADDRESS: _2425 MAYPORT RD, ATLANTIC BEACH9 FL 32233
PERMIT##
Signature of Notary Public
DARLENE DENNY SCHAUMANN
*; MY COMMISSION t FF 906694
P EXPIRES:August 4,2019
•4`t`°P Bonded Th.Notary Pubie Undern ten