Permit Temp Pole 445 Sargo Rd 2013 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002310 Date 3/13/13
Property Address . . . . . . 44S SARGO RD
Application type description ELECTRIC ONLY
Property zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0 -----------------------
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Application desc
temp pole -----------------------
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Owner Contractor
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IMPULSE ELECTRIC
BAKER, BEAUTY M 4271 YVONNE TERRACE
445 SARGO ROAD FL 32068
ATLANTIC BEACH FL 32233 MIDDLEBURG
(904) 214-422S
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Permit . . . . . . ELECTRICAL PERMIT
Additional desc - - 90 . 00 Plan Check Fee . 00
Permit Fee . . . . Valuation . . . . 0
Issue Date . . . .
Expiration Date 9/09/13 --------------------------------
------------------------------------STATE ELEC DCA SURCHARGE 2 . 00
Other Fees . . . . . . . . . STATE ELEC DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
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
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845 /0
JOB ADDRESS: S/(f f-010 gt>I —PERMIT# 15Z�;?
JEA INFORMATION REQUIRED ON ALL PERMITS le 0 AMPS 2 140 VOLTS PHASE
VALUE OF WORK$
NEW SERVICE 0 Overhead E] Underground Underground up Pole
EResidential(Main��ice
–1, 01-150amps El 151-200amps El amps of Meters
ommercial am ervice
E30-100 amps Ell -150amps 11 151-200amps amps _0 CT Service amps
Conductor Ty e .- Size
EMulti-Family(Main) Service
CO-100 amps [1101-150amps El 151-200amps F]—amps of Unit Meters
XTemporary Pole amps
SER ICE UPGRADE am s _1 CT Service amps
NEW FE ER(ADDITIONS,ACCESS STRUCTURES,ETC.)
E110 s El 150amps 00amps L-I_amps ECT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 3 1-1 00amps 101-200amps
Appliances: 0-30amps 3 1-1 00amps 101-200amps
A/C Circuits: 0-60amps 6 1-1 00amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
L'Swimming Pool El Sign El Smoke Detectors_Qty []Transformers_KVA []Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty_volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
[]Replace Bumt/Damaged Meter Can []Safety Inspection L]Panel Change OOH to UG
E 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 kikl� Phone Number
Electrical Company 1E, E�4 Office Phone "W_214-��_Fax
Co. Address: City Vi LMC�EZLV& - State Zip
License Holder(Print): State Certification/Registration
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