1031 Atlantic Blvd 2014 lite pole parking lot CITY OF ATLANTIC BEACH
f 800 SEMINOLE ROAD
r� ATLANTIC BEACH,FL 32233
J 4 INSPECTION PHONE LINE 247-5814
��*1131 Vii,
14-00000668 Date 4/28/14
Application Number 1031 ATLANTIC BLVD
Property Address WACHOVIA # 965
Tenant nbr, name . . • • •
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . .
0
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Application desc
light pole for parking lot
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Contractor
Owner ----------
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RIGHTWAY ELECTRICAL CONT. IN
WACHOVIA BANK NA
C 3551 SANCTUARY WAY S
/O THOMSON REUTERS
O BOX 2609 JACKSONVILLE BEACH FL 32250
P
P 0 BOX CA 92018 (904) 955-1630
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Permit
• ELECTRICAL PERMIT
Additional desc Plan Check Fee . 00
Permit Fee 55 . 60 0
Valuation
Issue Date • • ' . 10/25/14
Expiration Date ----
. STATE ELEC DCA SURCHARGE2 . 00
Other Fees 2 . 00
• STATE ELEC DBPR SURCHARGE -_--
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-----------
Due
Char ed Paid--- Credited
Fee summary g ----------
---------- . 00
_ ------------ 55 . 60 55 . 60 . 00
Permit Fee Total 00 60 . 00
Plan Check Total 4 . 00 . 00 . 00
Other Fee Total 4 . 00 00 . 00
Grand Total 59 . 60 59 . 60
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
.TOB ADDRESS: '�S`3 4T1,4 rig R/i/vl PERMIT# ��—
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑J Underground up Pole
❑Residential(Main) Service
[10-100 amps [1101-1 50amps [I151-200amps ❑ amps #of Meters
❑Commercial(Main) Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps 0 C Service amps
Conductor Type Size
❑Multi-Family(Main)Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps 6d j�_amps OCT 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 ❑Transformers KVA ❑Motors hp
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty
FIRE ALARM SYSTEM (Requires 3 sets of plans) VALUE OF WORK$
Qty volts/amps
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change COH 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 W&d 0V A 04 N L( Phone Number
Electrical Company IZI6PD.M>1 ,EILCTIL'c4( CoN7�arrr�� _Office Phone i-; �1 l° S' Fax k 2
Co.Address:
City IA�,r r'+ I4 State F( Zip 3 Z
License Holder(Print): State Certification/Registration# r 3 o c, u 1 1�-
Notarized Signature of License Holder
Before me this day of 20
Signature of Notary Public