1241 Ocean Blvd 2014 TEMP POLE CITY OF ATLANTIC BEACH
i 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00000858 Date 5/28/14
Property Address . . . . . . 1241 OCEAN BLVD
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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EZELIUS, PER OLOF KNIGHT ELECTRIC LLC
908 11TH AVE S
356 10TH ST
ATLANTIC BEACH FL 32233 (ACK ONVIL E BEACH 884 FL 32250
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Permit . . . . . . ELECTRICAL PERMIT
Additional desc . Plan Check Fee . 00
Permit Fee 90 . 00 .
Valuation
Issue Date
Expiration Date . . 11/24/14
_ _ ------
Other Fees
STATE ELEC DCA SURCHARGE 2 . 00
• STATE ELEC DBPR SURCHARGE 2 . 00
Fee summaryCharged Paid Credited Due
----------
. 00
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- . 00
Permit Fee Total 90 . 00 90 . 00 00 . 00
Plan Check Total • 00 . 00
Other Fee Total 4 . 00 4 . 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 �r
800 Seminole Rd, Atlantic Beach,FL 32233 t(
Ph(904)247-5826 Fax(904) 247-5845 1 u
'l �L�I+1'V PERMIT
JOB ADDRESS: 2`
JEA INFORMATION REQUIRED ON ALL PERMITS
AMPS 2� VOLTS PHASE
VALUE OF WORK$
Under DUnderground up Pole
NEW SERVICE ❑ Overhead F-1Undergroundg
❑Residential(Main) Service #of Meters
❑0-100 amps ❑101-150amps [I 151-200amps ❑ amps
❑Commercial(Main) Service ❑CT Service amps
❑0-100 amps ❑101-150amps El151-200amps ❑ amps
Conductor Type Size
❑Multi-Family(Main) Service #of Unit Meters
g0-100 amps ❑101-150amps ❑151-200amps ❑ amps
®'Temporary Pole ❑amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
s CCT Service amps
❑100 amps ❑150amps ❑200amps ❑ amP
REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
ADDITIONS,REMODELS,
0-30am s 31-100amps 101-101
Outlets/Switches: p 31-l 00amps 101-200amps
Appliances: 0-30amps
0-60amps
A/C Circuits: 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&Fire Alarm Checklist) VAL UE OF WORK$
Qty volts/amps
REpAIRS/MISCELLANEOUS
El Inspection ❑Panel Change ❑OH to UG
❑Replace Burnt/Damaged Meter Can
❑Other:
wo7k is—suspended or abandoned Permit becomes void if work does not commence within aCec month nOof laws and ordinances governi gfthis or d orlwo k will be co plied witx months. I h certifyh whether e
read this application and know the same to be true and cor provisions
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 o
construction.
Phone Number
Property Owners Name ,�( -�9 c/, F
Electrical Company ax
rV �r �Z�L �` �— Office Phone �
p _ S city_ (� State F/ Zip Z 2
ALt�Co.Address: ( U/2523
NC-VL-
Notarized
j� w, � State Certification/Registration# 3
License Holder (Print):
Notarized Signature of License Holder day of:j 20
Sworn and subscribed before me this
Signature of Notary Public