10 10 TH ST #65 -16-ELEC-744 elec permit �. ' s, CITY OF ATLANTIC BEACH
�' ,-Li.,_,:...,) 800 SEMINOLE ROAD
Jlify � 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: 16-ELEC-744
Job Type: ELECTRIC ONLY
Description: ELECTRICAL - 100 SWITCHES, 3 APPLIANCES, 60
FIXTURES, & MISC
Estimated Value: $5,000.00
Issue Date: 3/28/2016
Expiration Date: 9/24/2016
PROPERTY ADDRESS:
Address: 10 10TH ST 65
RE Number: 170237-0142
PROPERTY OWNER:
Name: FORT. ELIZABETH LEE
Address: 10 10TH ST APT 65
GENERAL CONTRACTOR INFORMATION:
Name: MUNSON & BRYAN ELECTRICAL CO.
Address: 3434 ST AUGUSTINE RD QA JOHN MICHAEL SCIOLINO
Phone: - -
FEES: - -- -- - —
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Electrical Repairs $35.00
Trade Permit Base Fee $55.00
Total Payments: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITII ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233 /
n�� Ph(904)247-5826 Fax (904)247-5845 l ' E L E C—7' ,
JOB ADDRESS: /D /A 5 F/et* Z/y,01— ‘ ,S PERMIT#
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JEA INFORMATION REQUIRED ON ALL PERMITS /SO AMPS VOLTS / PHASE
VALUE OF WORK$ _5'400 61., 4"()
NEW SERVICE ❑ Overhead ® Underground nJ Underground up Pole
Residential(Main)Service
0-100 amps G)/101-150amps 1 :151-200amps ! amps # of Meters
ICommercial(Main Service
0-100 amps 101-150amps 151-200amps amps CT Service amps
Conductor Type Size
i 1 Multi-Family(Main)Service
10-100 amps 101-150amps 15 1-200amps amps #of Unit Meters
Temporary Pole ' ! amps
SERVICE UPGRADE amps CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
100 amps 150amps 1200amps amps CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: /1O 0-30amps 31-100amps 101-200amps
Appliances: 5 0-30amps 31-100amps 101-200amps
A/C Circuits: / 0-60amps 61-100amps
Heat Circuits: / # circuits @ kw
Number of Lighting Outlets, Including Fixtures: 6°
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 Safety Inspection Panel Change ' !OH 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. / / 4
Property Owners Name eg fr�Ol`/ Phone Number l‘75"
Electrical Company fimie son 44d 8 efrcfr/L Office Phone iaf?l'i-'�Coaax 3%--0,7c
Co. Address:3 13V c/a 1 c/-sic Q City-5"SG4,S6.7 w/k. State f& Zip,3Z a7
License Holder(Print): X611 4 S4(5 f/ Sta Certification/Registration# 16,000/7 9 S
Notarized Signature of License Holder
•.MEi"•• JOSEPH GUY CAUCHON Swo and subscribed before me this t g day of Aare.* 20 Flo
_.. :4 Commission#FF 244825 Signature of Notary Public oAe.lk
? 4 Expires July 16,2019
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