358 5th St temp pole 2012 �� ?t!r�►�1ff J�.�
It, CITY OF ATLANTIC BEACH
l 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
J v INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001619 Date 11/02/12
Property Address . . . . . . 358 5TH ST
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . RES SF DISTRICT
Application valuation . . . . 0
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Application desc
temp pole
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Owner Contractor
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AF AB VENTURE LLC KNIGHT ELECTRIC LLC
800 3RD ST STE C 910 11TH AVE S
NEPTUNE BEACH FL 32266 JAX BEACH FL 32250
(904) 247-9884
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Permit . . . . . . ELECTRICAL PERMIT
Additional desc . . TEMP POLE . 00
Permit Fee 90 . 00 Plan Check Fee .
Issue Date . . . Valuation 0
Expiration Date . . 5/01/13
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Other Fees . . . . . . . . . STATE ELEC DCA SURCHARGE 2 . 00
STATE ELEC DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
_ ----------
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Permit Fee Total 90 . 00 90 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 94 . 00 94 . 00 . 00 . 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 t'A
800 Seminole Rd, Atlantic Beach, FL 32233 9-
Ph(904)247-5826 Fax(904) 247-5845
JOB ADDRESS: )5 Wt6l' PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS S-U AMPS VOLTS ! PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑J Underground up Pole
❑Residential(Main),�rvice
00-100 amps -4110 1-150amps El151-200amps ❑ amps #of Meters
[]Commercial(Main)Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps [ICT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
�
0-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
emporary Pole ❑ t7 amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps ❑200amps ❑ amps ❑CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-3 Damps 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
[]SwimmingPool ❑ Sign []Smoke Detectors_Qty ❑Transformers KVA [I Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans&Fire Alarm Checklist) VALUE OF WORK$
Qty volts/amps
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.
Property Owners Name Phone Number
Electrical Company +�N� IX �Lt 2t� CCS Office Phone 2'd7-9$S'y Fax 2y? WO
Co.Address: 7� D /I� � �— City 'h� �^• State Zip 727-5-0
License Holder(Print): efJ �Wilk r State Certification/Registration# WJ?025-2-3
Notarized Signature of License
SHIRLEY L G 20
MY COM1�MSSIC�N a oo Wo d subscribtblicef this day of
February 2014
�,•. :;; EXPiFlES:Februa 14,
�F•F};; � Bonded Thru Notary Public U re of Notary
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