1600 Selva Marina Dr iv14-00000145 (Temp Pole) s ` J S, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . .
14-00000145 Date 1/31/14
Property Address . . . . . . 1600 SELVA MARINA DR TP02
Tenant nbr, name . . . . . . TP01 TEMP POLE
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . .
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Application desc
TEMP POLE TP02 - 400 AMP SINGLE PHASE- -
Owner -- -- - -- --- ---------------------
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Contractor
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_ _ - --- --- -- -
SELVA MARINA COUNTRY CLUB AMERICAN ELECTRICAL CONTRACTOR
1600 SELVA MARINA DR 5065 ST. AUGUSTINE RD #13
FL 32207
ATLANTIC BEACH FL 322335616 (904)JACKSOI737-7770
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PermitELECTRICAL PERMIT
Additional desc . . TEMP POLE TP02 400 AMP 1 PHASE . 00
90 . 00 Plan Check Fee 0
Permit Fee Valuation . • • •
Issue Date • • • . 7/30/14
Expiration Date . --- -
-- ----- - --
- -- 2 . 00
Other Fees
• STATE ELEC DCA SURCHARGE 2 . 00
• STATE ELEC DBPR SURCHARGE
_ - - ------
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Paid- Credited
Fee summary g - - - - --- -- -ue-
------- --- . 00
- - -- --- -- 90 . 00 - ----90 . 00 . 00
Permit Fee Total 00 00 . 00
Plan Check Total 00 00 . 00
4 . 00 4 . 00 . 00
Other Fee Total 94 . 00 94 . 00 . 00
Grand Total
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
ADDRESS: I Se�ur, 6��C% U r P 01�� PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS _AMPS 2 V(IVOLTS PHASE
VALUE OF WORK$ z IT
NEW SERVICE ❑ Overhead ❑ Underground nderground up Pole
Residential(Main) Service
10-100 amps 101-150amps i 151-200amps 1 amps #of Meters
Commercial(Main) Service
0-100 amps 101-150amps 1151-200amps amps CT Service amps
Conductor Type Size
Multi-Family(Main)Service
0-100 amps 7 101-150amps _1151-200amps amps #of Unit Meters
temporary Pole =1��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: 0-30amps 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 `_iSmoke Detectors_Qty Transformers KVA Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans) VALUE OF WORK$
Qty volts/amps
REPAIRS/MISCELLANEOUS
r Can []Safety Inspection Panel Change [10H to UG
Replace Burnt/Damaged Mete
)(Other: V►rl U�C fn / t�
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 �1 n �l �( r� CILAb Phone Number
Electrical Company 1 A u I Co �a Lf- Office Phone ���'��� ��iLlFax
' � - ,p p 3;taD�
Co. Address: �lxo 3 5 �� �5�` 1�� City i~c e- State Zi
State ati n/Re ' tration# �C�C� 311p
L' ,e Holder (Print):
Notarized Signature of License Holder
�.► Notary Public State of Florida Sworn and subscribed be ore me t is ay f Cl�I�Q 20
Anna M Daly
My commission EE 850790 Signature of Notary Pub is
�ti Expires 01/25/2017