1500 W Park Ter 2013 Temp Pole CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00003625 Date 11/08/13
Property Address . . . . . . 1500 W PARK TER
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
temp pole 40 amps
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Owner Contractor
_ ------------------------
OSSI DEVELOPMENT INC KNIGHT ELECTRIC LLC
1112 3RD ST. SUITE 4 910 11TH AVE S
NEPTUNE BEACH FL 32266 JACKSONVILLE BEACH FL 32250
(904) 247-9884
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Permit . . . . . . ELECTRICAL PERMIT
Additional desc . . 40 AMPS TEMP POLE . 00
Permit Fee 90 . 00 Plan Check Fee .
Issue Date . . . Valuation 0
Expiration Date . . 5/07/14
_ ------------------------------
Other Fees .
_ STATE ELEC DCA SURCHARGE 2 . 00
STATE ELEC DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
g ----------
----------
----------------- ---------- -
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_ 60
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845 a
SOB ADDRESS: / �0 PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 1/0 AMPS VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑J Underground up Pole
❑Residential(Main) Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
❑Commercial(Main) Service
E0-100 amps ❑101-150amps ❑151-200amps ❑ amps JCT Service amps
Conductor Type Size
JMulti-Family(Main)Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
remporary Pole ❑amps
SERVICE UPGRADE LI—amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps ❑200amps ❑ amps DCT 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 ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans) VALUE OF WORK$
Qty volts/amps
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can IJ Safety Inspection ❑Panel Change 01 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
r t(Cut? L L l C— Office Phone Fax
Co. Address:
7`g I/'' live §4-4kCity -TAt !k i State r/ Zip 72 2 P
License Holder (Print):
�yc rAX r State Certification/Registration# Cil?o(ZX2.)
Notarized Signature of License Holder
Before me this day of 20
Signature of Notary Public