2050 Beach Ave POOL 2014 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
Application Number . . . . . 14-00001129 Date 7/24/14
Property Address . . . . . . 2050 BEACH AVE
Application type description SWIMMING POOL/SPA
Property Zoning . . . . . . . RES GEN MF DISTRICT
Application valuation . . . . 35000
----------------------------------------------------------------------------
Application desc
NEW POOL
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
CDL AB LLC ISLAND POOLS, LLC
335 11TH ST 1546 LINKSIDE DR
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 334-5421
----------------------------------------------------------------------------
Permit . . . . . . SWIMMING POOL
Additional desc . .
Permit Fee . . . . 225 . 00 Plan Check Fee 112 . 50
Issue Date . . . . Valuation . . . . 35000
Expiration Date . . 1/20/15
----------------------------------------------------------------------------
Special Notes and Comments
Full right-of-way restoration, including sod, is required.
Full erosion control measures must be installed and
approved prior to beginning any earth disturbing
activities . Contact Public Works (247-5834) for Erosion
and Sediment Control Inspection prior to start of
construction.
2010 FLORIDA BUILDING CODE, 2008 NATIONAl ELECTRIC CODE
REQUIRED INSPECTIONS :
*POOL STEEL
*ELECTRICAL GROUNDING AND BONDING
*FINAL (PUMPS MUST BE RUNNING FOR FINAL)
SWIMMING POOL SAFETY INSPECTION REQUIRED
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE DCA SURCHARGE 3 . 38
ENG REV PRE APP > 3 HRS 25 . 00
STATE DBPR SURCHARGE 3 . 38
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 225 . 00 225 . 00 . 00 . 00
Plan Check Total 112 . 50 112 . 50 . 00 . 00
Other Fee Total 31 . 76 31 . 76 . 00 . 00
Grand Total 369 . 26 369 . 26 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEAIENT
State Of Tax Polio No.—169712-000
County of_lDuval
To Whom it May Concem:
The undersigned hereby inform you th' � 'n1provem'sn'ts will be made to certain real property,and in accordance with Section 713 of
the Florida Statutes,the following infort, -
Q is stated in this NOTICE OF COMAENCEMENT.
Legal Description ofpropertybeing'MV. 4: 15-93 9-2S-29E.22 N ATLANTIC BEACH UNIT NO 3 PT
Address of property being ftproved:__ �030 Beach Avenue.Ad Bch fL 32233
General descriptiont of improvements:—Swimming pool
Owner—CDL AB LLC Ad& --- 355 11*Street Atl Bch FL 32231
Owner's interest in site of the improvement 1000/9
]Fee Simple Titleholder(if other than owner):
Name:
Contractor:—Ronald Gray Island Pools LLC
Addresq:_1546 Linkside)Dr Atl Bch FL 32233
TelOP110110 NO-: 334-5421 Pax No.
Surety(if any)
Address:
Telephone No: Amount OfBond S
Fax No:
14ame and address Of any person m*itg a loan for the construction of the irWovements
Nanw:
Address:
Phone No: Fax No:
Name Of Person Wi*h the State of Florida, other than himelf, desPated by Owner Upon whom noti0es or offier documents may be
served: Name:
Addrm:
Telephone No:
Fax No:
Tn addition to hfinself, owner desigmdes the following Person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Stanje$. (FjU in at Owner.$option)
Name:
Address:
Telephone No: Fax No:
Expiration,date of Notice of Commencement(the expirntion date is one(1)Ym from the date of recwiing unless a different date is
specified):
THIS SPACE FOR RECORIDERIS USE ONLy ()WNER 2
Signed:
Date-
Before me this day of I —IL�
!e V �–QAY 'pull
Doc#2014165500.OR 5K 16= Page 1758, Of Florida,bw r,&Wly appeared 9 E��tn the County of Duval,Stft
Number Pages:1 Notary Public at Largo,State of �0�da,County of Duval.
Recorded 07124/2014 at 04:24 PM,
Ronn!e Fussell CLERK CIRCUIT COURT DUVAL MY cornaiission
COUNTY personally Kn
owxc�2�
RECORDING$10.00 Produced Identifleation:
KAY W-rzL SMITH
Q;iq COT091"#FF
- ExM=Noveadw 30. 7
BUILDING PERMIT APPLICATION
A
TY OF ATLANTIC BEACH
FILE COPY
800 Seminole Road,Atlantic Beach, FL 322
ir45 '
Office (904)247-5826 Fax(904)247-5 4
Job Address: 2050 Beach Avenue Permit Number:
Legal Description 15-93 9-2S-29E .22 N ATLANTIC BEACH UNIT NO 3 pT
Parcel# 1697M-0000
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ 35000 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/pro osed structureQ)(�ircle one): Commercial Residential
If an existing structure,is a fire sprinmer system installed? (Circle one): Yes No N/A
Florida Product Approval #
For multiple products use product approval form
Describe in detail the type of work to be performed: In ground pool
Provertv Owner Information:
Name: CDL AB LLC Address: 3 5 5 11 th St
City AB State FL—Zip 32233 Phone 3345421
E-Mail or Fax#(Optional
Contractor Information:
Company Name:1sland Pools LLC Qualifying Agent: Ronald Gray
Address:1546 Linkside Dr City AtIBch State FL Zin 32233
Office Phone 334-5421 Job Site/Contact Number 334-5421 Fax#
State Certification/Registration# CPC 1457429
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
ca e e gde b an a perm, �do he work and allati Ins as ind�c or installation hay commenced prior to the
A to 0 r, i t 0 t e to in� i;ta a thisjurisdiction. This permit becomes null
pp'i 'io S' r by th , 11 ' ' ill b e r d
uance a perm a a a w w rm r
0 k s a Period ofsix months at any time after
ss in t Od r
i,(6 on orl c c'on or
c r, f
or I ctnc W
0 0'o 0 ep) Ob i -s,Heaters,
s not com enc L
and' id k i 1, in rst ed w thin s
,c ;a " t t sp r Per iis mu t
work is c f me ed nde d a ate d Ee Ws,Pdols, rnaces,Boilei
0
Tanks aWAir Con doners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOVIi NOTICE OF
COMMENCEMENT.
I herelb certify that I have read and exa i.ned th* plication and know the same to be true and correct. All provisions oflaws and ordinances governing this
n's
work will be cotnplied with wh t er sEc,7,ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions ofany otherfederal,state, or al aw regulating construction or the peFfo�mance ofconstruction.
Signature of Owner 1_4� Signature of Contract1q,
Print Name Print Name
-A
Sworn to and subscribed before me Sworn toyand subs ribe before me
this Day of 20 this L.C 01
LDayof My 2
Rotary P
y6lic No T
&W"� ;rY KEEL SMITH
44 Commission#FF 040768 e sed 0 1.26.10
KAY KE;L S;1TH Expires November 30,2MO#
Commission#FF 040768
Expires November 30,201J7
Ulded nN Tmy Fak I 80moale
Isla" foobux
Impervious calculations for 2050 Beach Avenue
Current lot size 9375 sft
Post construction impervious
House 3243 sft
Pool bath 528 sft
Drive and walkways 516 sft
Pool deck 359 sft
Pads 27 sft
Total impervious area 4673 sft
Total impervious percentage 49.8%
7,
Completed by
FILE COPY
RD Gray j
Island Pools LLC
REVIMD FOR CODE COMPLIANCE
904-334-5421 CM OF ATLANTIC BEACH
SEE PERM17s Ff-)k ADDITTOt
REQ1J1RFMf-.T1'7r,AND CONJ)Fwll��I.
""'WED BY: DATE,
�-7V==�-777
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d
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v oil
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<
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r, &I 1� I
ONLYSLOW
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I 110�0'� 9
r
"DCM4WW MW
(NWW a I SM&W Fm"Aa)
Z
SEMINOLE ROAD
MW Mff OF MY F%%W MM OWD
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C.,I cl
lot
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(D
d)
ANSI/ASP-7 2006 Specifies three methods for determining the maximum system flow rate. The following simplified TDH
calculation is one of the methods specified.
I —
Simplified Total Dynamic Head (TDH) Calculation Worksheet
TDH Calculation Options
For each pump
Check One.
F71 Simplified Total Dynamic Head (STDH)
Complete STDH Worksheet—Fill in all blanks
Total Dynamic Head(TQH)
Complete Program or other calcs. Fill in
reauired blanks on worksheet&attach calculations.
Determine Maximum SVstem Flow Rate:
Minimum Flow Rate Required: 35 gpm Per Skimmer
1. Calculate Pool Volume: 430 X 4.25 x 7.48 (gal./cubic foot) L4000
(Surf.Area) (Avg.Depth) (Vol.in gal.)
2. Determine preferred Turnover Time in hours: 6 x 60 (min./hr.) 360 —
(Hours) (Turnover in Min.)
3. Determine Max Flow Rate: 14000 360 = 0 + 0 = IS GPM
(Vol.in gal.) (Turnover Mins.) (Pool Flow Rate) (Feature Flow Rate)(System Flow Rate)
4. Spa Jets: o X 0 gpm per jet= o flow rate.
(No.of Jets) (Jet Flow) (Total Jet Flow Rate)
(For single pump pool/spa combo, use the higher of No. 3 or No. 4 in the following calculations for the pool&spa)
Determine Pipe Sizes:
Branch Piping to be 2 inch to keep velocity @ 6 fps max. at L2_gPm Maximum Systern Flow Rate.
Trunk Piping to be 1.5 inch to keep velocity @ 8 fps max. at jo_gPm Maximum System Flow Rate.
Return Piping to be 11.5 inch to keep velocity @ 10 fps max. at L2_gPm Maximum System Flow Rate.
Determine Simplified TQIH:
1. Distance from pool to pump in feet: 30
2. Friction loss(in suction pipe) in 2 inch pipe per 1 ft. @ 62 gpM 0.06 (from pipe flow/friction loss chart)
3. Friction loss(in return pipe) in 1.5 inch pipe per 1 ft. @ 50 gpM = 0.14 (from pipe flow/friction loss chart)
4. 30 X 0.06 1.8
(Length of Suct.Pipe) (Ft of head/1 ft of Pipe) (TDH Suct.Pipe)
5. 30 X 0.14 —= 4.2
(Length of Return Pipe) (Ft of head/I ft of Pipe) (TDH Return Pipe)
TDH in Piping: 6
Flow n Loss Per Foot
Schedule 40 Pvc Pipe
Velocit Feet Per Second Filter loss in TDH (from filter data sheet): 15
Pi e Size 6 fps I 7f:8:f�s
I" 16gpm 1 0.14' 1 21qpm 1 U-23' 1 Heater loss in TDH (from heater data sheet): 15
1.5" 37— 1 0 0A' I
Zgpm 2
0!22
0, 0.13' Total all other loss: -0
88 rn 5, 1 M7g 9PM
I 138gpm 0.04' 1 181 m U-u' ZZ/ m U.
and Frictio
lof s
lof
6 %26 ; 0.35;
1 m
7 62 m 0.21
10
62 103,prn 0 16'
2
88'
I 3e
234gpm 13gpm 0.05' 392gpm 0 7' 36
4 Total Simplified TDH:
6" 1 534gpm 0.02' 712gpm I U-W 1
Page 1 f 3
http://www.flagiercounty.org/doc/dpt/centprmt/build/headcaicsws-pools3-0g.pdf 4
I -,ER ORE, PE 55740
Revised 7/2009 SAMU UBER
ROGERS ST
-'&-E. .-iWATER, FL 33756
Y27-442-8443
Selected Pump and Main Drain Cover:
Pump selection Intelliflo VS 3050 (Pump Model and size in Horsepower) using pump curve for Simplified
TDH & System Flow Rate.
Main Drain Cover Waterway640 (System Flow Rate must not
(Make and Model)
exceed approved cover flow rate)
Notes: Minimum system flow based on min. flow per skimmer of 35 gpm.
Determine the Number and Type of Required In-Floor Suction Outlets:
Check all that apply.
57-1 3'—0" 2 8" suction outlets @ 100 gpm max, flow(see note 2).
LD @) @) @) 3 suction outlets @—9PM max. flow(see note 3).
F-1 Channel Drain @ 316 gpm max. flow rate.
Channel Drain @ 217 gpm w/2 ports&278 gpm w/3 ports (see note 4).
Notes:
1. If a variable speed pump is used, use the max. pump flow in calculations.
2. For side wall drains, use appropriate side wall drain flow as published by manufacturer.
3. Insert manufacturer's name and approved maximum flow.
4. See installation instructions for number of ports to be used.
5. In-Floor suction outlet cover/grate must conform to most recent edition of ASME/ANSI
Al 12.19.8 and be embossed with that edition approval.
6. Pump & Filter make, model and location cannot change without submitting a revised plan and
TDH worksheet.
I
RD Gray
Contractor Name Contractor Signature
CPC1457429 June 13th 2014
Contractor License Number Date
(904)334-5421
Telephone Number Email Address
(2
SAMUEL LIBERATORE, PE 55740
1268 ROGERS ST
CLEARWATER, FL.33756
727-442-8443
Page 2 of 3
http://www.flaglercounty.org/doc/dpt/centprmt/build/headcaicsws-pools3-09.pdf
Revised 7/2009
Total Head In Feet Conversion Chart
Inches Mercury (Vacuum Gouge)
0 1 2 1 4. : 6 8 1 10 12 14 16 18
-T 2-
q 4,5 i U 11.3 13.6 15.8 18.1 2OZ
2,3 4.6 6,8 --9.1 11A 13.6 15.9 18.1 20A 22.7
91 11,4 13,7 1 2 20.4 22-7 25.0
2
0.9 1 9.2 11.5 13.7 16,0 #12q.A_ 22.8 2M 27-3
4 1 9.2 11.5 1 al 1 -1 AA- 20.5 1 Z2.8 25.1 27.3 29.6
5 11.5 13.8 15.1 1B.3 20.6 22.8 25.1 77.4 29.6 3L9
.2
5 13.9 1 161 18.4 20 22.4 _�Z,4 3? 31,9 34.2
-7--T-16.2. 1184 ---YO.7 _210 25.2 1 27,5 29.7 32.0 34.3 36.5
-24.8 -T
-7--T 32b 4.3
8 1 B.5 1 20.7 23.0 t 252*7 27.5 T-
3&6 38.8
36.6 38.9 41.1
9 20.8 23.1 25-3 27.6 29.8 32.1 1
-23.1 25.4 27,6 N.9 32A 34.4 .9 41.2 43.4
4'-i�.q -SZ-
.2 34-5 X7
12 2 . 30.0 32.2 34.5 36.8 39,0
-4
13 30.0 1 32.3- 34.6 36.0 39.1 41.3 416 45.9 48.1 50.4
3 2 T 34.6 36.9 39.1 il.4
2 41 45.9 48.2 50.4 52.7
15 34.6 36.9 39.2 1; 41,4 43.7 45, 48.2 50.5 5W 55.0
16 37.0 39.2 .5 Q.7 46,0 40.3 50.5 i 52.8 55X 57.3
1 41.5
17 39.3 Of 46.1 W 50.6 52.8 55.1 57.4 59.6
03 18 41.6 43.8 4&1 48.4 50.6 52.9 55.1 57.4 9.7 61.9
64
-57.4 --ii.7 62.0
CC 19 43.9 IL2 �_48.4 50.7 52,9 55.2
20 4.6.2 0.5 1 50.7 53.0 55.2 57.5 59.8 62-0 64,3 66.5
21 48.5 50.8 53.0 55.3 i 57.6 59.5 1 62,1 64.3 66.6 68.9
22 503 Ki.-I 55.3 1 5716 59S 611 64.4 66.6 68.9 71.2
22 53.1 .35.4 _2L7 j 59.9 62.2 64.4 66.7 69.0 71.2 73.5
24 55.4 57.7 50.0 1 62.2 64.5 1 66.7 ki 71.3 73.5 75.8
-3 60.0 62J 64.5 1
--�S 7.8 66.8 6-9.1 71.3 73.6 75.8 78.1
26 60.1 62Z 64.6 66.8 69.1 71.4 73.6 75.9 7&1 80.4
59.2
27 62.4 64.6 6&9 �.4 �1�7 7&9 82.7
28 64.7 66.9 69.2 71.5 73.7 76.0 78.2 80.5 W-8 .0
715
75
29 67.0 69 3 . 71.5 73A 76.0 78.3 8
0.5 82..8- 85.1 97-3
692 71.6 1 73.8 76.1 7&3 30.6 8Z9 a5.1 i 87.4 89.6
31 71.6 73.9 7111 78A 80.7 82.9 87A 89.7 92.0
'7
---i� , 9 ;5
32 73,9 76. 8.4 80.7 -i6.0 .2 89.7 92-0 1 94.3
33 75.2 78.5 1M.7 $3.0 85.3 B7.5 89 --ii-o T-%' .Z 96.6
34 78.5 80.8 B3.1 85.3 87.5 89.8
6.6 98.9
loll
8EL9 8341 55A 97.6 89.9 92,2 94.4 j 96.7 X9 101.2
L
/1 14)
SEAMUE-i- LIBERATORE, PE 55740
1268 ROGERS ST
G 01.
-.ij� \R%NATER, FL 33756
727-442-8441-3
Page 3 of 3
http://www.flagiercounty.org/doc/dpt/centprmt/build/headcalcsws-pools3-09.pdf
Revised 7/2009
rOO VS 3050 High Performance Pump
Dimensions and Performance
OL
NSF
LISTED CSAC-'"Od Usted
120-
100-
rpm
80
@3110rpm—****�
(a-YZ'35q rpf#
40-
20 -.,0,15560 rp
0 rp
0
0 20 40 60 80 100 120 140
US.Gallons per rnipute
-T I I
20 25 30 35
5 10 15
Cubic Meters per hour
26.,06
r^If
----11.047
7-
t
1075
*nt parts
Intelli IoOVS 3050 & 1nte11iF1oVS+SVRS
High Performance Pump
Featured Highlights
Slashes energy costs up to 30%or mor
4 E
Belect - Easy to program and operate
- Offers ultra-quiet operation ...just 7—
decibels or half a human whisper
- Operates at the minimum speed requii
for unmatched longevity
Compatible with other pool systems,
including EasyTouch*�IntelliTouch'*,anc
IntelliFloVS 3050 High Performance Pump SunTouch-
Patents Pending
lntelliFloPVS 3050 allows the programming of four various speeds
ranging from 400 to 3450 RPMs to accomplish different tasks at
lowest energy usage.
Ordering Information
Full Load Fort Size(NPT) Cartor
Product Description Certifications Voltage kW HP SF SFHP Suct.&Disch. (Lbs
Am s
INTELLIFLOVS 30SO PUMP
011013 IntelliFloVS 3050 UL,CSA.NSF 230 16 3.2 3 1.15 3.45 2" 47
011017 InteIlIFloVS+SVR.S UL,NSF 230 16 3.2 3 1.15 3.45 2" 47
ACCESSORIES
520641 IntelliComm 4
350122 50'Communication Cable'
'Included in package with pump.
MAY
SYSTEMW
Repair parls—see page 170
it
PUA SERIES — Sla-Rile's mOdUlar media fillralion is the perfect rnalch
lot- (lie small in-Qr0LInd and aboVe-grOLInd pool markets. Advances
it) modia lochnology and balanced flow clesign provide dirl-lctading
capabilities tip to 15 limes greater than sand fillers of eqLlivalenl size.
Vil tLI,1I ly ma I ni enance-free operal ion for today's pool owner N ow
Ivililable Ili 300 sq. ft!
CERTIFICATIONS — The filter shall be tested and certified by a
nationally recognized lesting laboratory to conform to NSF Sid. 50.
USE,
Typical installation — in-ground the smaller System*2 filter, enobliti2 Large Drain Plug—Filter includes
pools and hot lUbs maintenance-free operation foi 2"NPT Drain ports,which are
Qualily Construction — DUrable, pools of all sizes provided with reducer bushing 3n
two piece lank IIOLI'.-,il)g cons1rucled Low Maintenance — Complele 1 J12"drain plug
Of ftlg�ed A13S therinoplaslic to media Coverage combined wilh Modular Filter Tanks—Allows
011SUrea long-lashng link life shallow pleats means greater dii I for quick change of filter medias
locking in
Easy Access— Posi-Lok holding capabilities,resullinq wilhoul chinging the lank
ling provides safe,fast access to longer filter cycles and leso; ripaning Sleek Looks—Contemporary
ank inlemals. A Perfect Fit—The small diamt-der style and malle black finish looks
Patented Design— The pilenled, footprint makes the System 2 filter attractive in any pool setting
innovalivo halanced flow design a perfect fit for new and retrofit
III-St 111110dl,ICI:�d Will) Ihtl Syslenv3 inslallilions.The inlerchangeble
Mod Media Idiot is now available in ports provide MUllipIC'PlUmbing
options.
rillel Optimal* flow Rated" TURNOVER RATE(GALLONS) lank Approx.
catalog Area Performance GPM (FLOW RATE x 60 if HOURS) Port Ship.Weight
Number (sq.f I.) at this GPM per sq.ft. Hr Size Obs.)
6 ..At B.H rs At 10 s�_
PLM 100 tO() 50 38 100 111 - 36.000 18 48.001.1 ,j 60.000 2.1 1111
PLM I;IS 5U 94 47- 125 17-115,000 22 -60.000 28 711,006
42
PLM 150 150 50- 113 56 150 20-5,1.000 27 72,oOu I'l 9U.600 21, 113
P L M I I!) 17.� 5 0- 120 66- 150 24 -54,000 11 72.00f) 31) 90,000
4q
I'L M,'OU �00 ,,0- 120 75- 150
27 -5,000 36 72.OUU 11) (J0,000 2.1 45
Pi M 100 100 50 120 113 - 150
41 -54.000 54 12.UOO hii IM.006 53
'Opel..1111q.11 1111.-k,PM�111 po.1-6-lhelnjige�l fillerrydescornhined with the hp%l andqre,.Iv�i(J.,i tav�vj 1.11,,area-oil pfovidelonqer
I'lle.I ydes hollwevn dvan,I)V.
-11.1%...I o.1 Nsf 11,1-rale for rominerciAl it 37f�nPm pe, squ.jrp lut)l
No h.1, j,j,jj,(j
Nor[.ojwlaimg I Iflawfolilm cm)IIIIII.-If opetaling ptes,;ure of ni)lost Pool/y;j jhaltwd alyfi-ov:ow, ju-1111imin upi-o-diiij water temperature
11111C111.11 Wit-0 11141 1,10 C)
............ ..............
Approx.ShIP-
Weight
Dmription U
0S 100 So.Ft.Replacement Module for PLM100 11.5
0125S 125 Sq.Ft.Replacement Module for PLM 125 12
0150S 150 Sq.Ft.Replacement Module for PLM150 13
175 .Ft.Replacement Module for PLM175 -
175S 200 Sq.Ft.Replacement Module for PLM200 14
200S 300 Sq.Ft.Replacement Module for PLM 300 19
-0300S 2"x 1-1/211 Pipe Reducer Bushing 8 oz.
20P
Snrind Cl
-0130S
PLM300
ILS1
100,
ISO,
e
,I
V44
VJ2
Will
r,NPI
TAR ME
1W T,KII
ISM
All dimensions shown In Inches.
;PLMj00'PLMU5.
.--1PLM150,PLM3L75,
PLM200,PLM300
10 20 40 60 So 100120 140 160
W RATE IN GALLONS PER MINUTE
41:1�'n
AIL A
- 7 0-231xv
' 77" 7W
8"Anti-Entrapment Main Drain Cover and Frame 0 0 0
Waterway main drain covers are compliant with the Virginia Graeme-Baker
Pool and Spa Safety Act(ASME/ANSI Al 12.19.8-2007)and are UL Certified.
They are designed for single or multiple drain use.This drain cover assembly
includes frame and stainless steel screws with brass inserts.Packed 25 per case.
The Waterway 640-231 x V series covers and frames are available in:
0 White J Bone 8 Black 0 Gray 0 Dark Gray 8 Beige 6 Dark Blue
Model No. Oescription Size Total Open Area Floor Flow Rate Wall Flow Rate Flow Rate GPM
Square Inches GPM GPM. 0 1.5 ft/sec
N ft/sec-
6'
6401.73ftkm
MOO??
08.650 -RONA
0 7.624
442-21ftV- r An*Atft:0rAk0W
7.000
819-00051
000
0 o,--- 642-215xV
;P"' U 0 0 4ft
0 4r%
0 0 0
qN�
100 01
�0 0 010A
010 00 .300
0
ON 0 — 0 0 642-214x
0 000 0 0-
'0
Lo. 0
.470
.975
.800
TM
02009 Waterway Plastics-2200 Sturgis Road,Oxnard,CA 93030-Ph.805-981-0262-waterway@waterwaypfastics.com www.waterwayplastics.com 807-0081.0309
GENERAL DESIGN REQUIREMENTS SPECIAL SPA REQUIREMENTS:.',.
-DESIGN,CONSTRUCTION AND WORKMANSHIP
-MAXIMUM WATER DEPTH 4',MAXIMUM SEA:r DEPTH
SHALL BE IN CONFORMITY WITH THE 28',MAX.
REQUIREMENTS OF ANSVNSPI 3,ANSVNSPI 4,ANSI/ -FLOOR SLOPE 1 12 14
NSPI 5,AND ANSVNSPI 6,ANSI/APSP 7 AND ANSFAPSP 15 R'ISER,12-MAX. 0)
-STEPS:MIN.TREAD 10"X 12',7'MIN.
BASED ON THE POOL TYPE. P ISER EXCEPT THE BOTTOM STEP MAY HE 14"IF IT Is
-SEE NSPI FOR DIVING WATER ENVELOPES. THE SEAT.INTERMEDIATE TREADS ANDRISERS TO
-SLIDES SHALL MEETTHE MANUFACTURE'S BE UNIFORM.IF THE SPA IS OPERATED
INSTALLATION REQUIREMENTS. INTERMITTENTLY IT SHALL HAVE A ONE HiOUR 3 4;
-ENTRYIEXIT:REQUIRED AT THE SHALLOW END AND t
TURNOVER,IF CONTINUOUS A SIXHOUR TURNOVER.
DEEP END IF OVER 5 FEET DEEP.ACCEPTABLE ARE
-MAXIMUM TEMPERATURE 104 DEGREES.
STAIRS(10-MIN TREAD WITH 240 SQUARE INCH MIN. 't
-MEET ANSYNSPI ARTICLE XVII,SAFETY
AREA,12'MAX.RISER WITH INTERMEDIATE TREADS INSTRUCTIONISAFETY SIGNS.
AND RISERS UNIFORM). LADDERS,UNDERWATER -PRESSURE TEST PIPING AT 35 PSI FOR 15 MINUTES OR
SEATS,AND SWIM OU'rS(MAX.20'BELOW WATER). MEET LOCAL CODE IF GREATER.
-CIRCULATION SYSTEMS,COMPONENTS AND
EQUIPMENT SHALL COMPLY WITH NSF 50. ELECTRICAL REQUIREMENTS:
-THE MAXIMUM TURNOVER RATE IS 12 HOURS.
-FILTERS SHA'-L HAVE AN AIR RELEASE AND -WIRING AND BONDING AND ALL ELECTRICAL TO
PRESSURE GAGE. COMPLY WITH CHAPTER 27,FLORIDA BUILDING
-PUMPS 3 HP AND LESS SHALL MEET ANSIJUL1081 CODE 2010 AND NEC 2008.
-NO OUTLET OR OVERHE AD POWER WTI TIN 101 IF
%IAtN DRAIN REQUIRE CORROSION RESISTANT WITH STRAINER AND MEET
fAMPFRPROOFISEENOTES) TIIE REQUIRED FLOW. WITHIN 15'PROTECT BY GFI.ITLANSFORMER MIN.I(Y
AGHTING&BONNNG SAME AS -SURFACE SKRAMEPS SHALL MEET NSF 50 AND FROM POOL,&'ABOVE WATER,J BOX*FROM POOL,
POOL THERE SHALL BE ONE FOR EVERY 800 SQUARE FEET BRASS TO J BOX OR TRANSFORMER WHICH EVER IS
OF SURFACE AREA. FIRST EXCEPT WHERE PVC IS APPROVED.
NO LIMITATIONS ON SHAPE -RETURN INLETS SHALL BE A MINIMUM OF ONE FOR FLORIDA BUILDING CODE R4 101
E VERY 300 SQUARE FEET.
�L SPA PLAN -HEATER SHALL MEET ANSI-Z21.56 OR UL 1261 OR TIFE POOL CONTRACTOR 18 RESPONSIBLE FOR
UL 559. FURNISHING ALL DETAIL DESIGN REQUIREMENTS
-DISINFECTANT EQUIPMENT SHALL COMPLY WITH FOR EACH INDIVIDUAL POOL IN ACCORDANCE WITH
NSF 50 THE FLORIDA BUILDING CODE,AND ALL
-PRESSURE TEST PIPING AT 35 PSI FOR 15 MINUTES OR CONSTRUCTION SHALL MEET ALL APPLICABLE
MEET LOCAL CODE IF GREATER. CODES INCLUDING PLUMBING,ELECTRICAL AND
GAS. PIPING SHALL BE SCH.40 PVC,NSFpw,MAX. cz
�C)R PERMUSHALL 6' PRESSURE VELOCITY 10 FPS,SUCTION 6 FPS.
THE POOL PLAN SHALL SHOW THE DESIGN
,:CIIEADOF60ft. PLUMBING AS PER THE SAMPLE WITH TTIE
INFORMATION REQUIRED SHOWN. MAIN DRAIN ;-4
PLUMBING SHALL BE TWO DRAINS SEPARATED BY Y 0
CD
quired:I Skimmer per$00 sf) WITH APPROVED ANSVASME A 112.19.8.2007 COVERS. AS Q)
IN
�t AN ALTERNATE TTIE APPROVED DRAW MAY BE
491 gaycf gallons PLACED ON DIFFERENT PLANES THE IWO DRAINS P4
LINE OF SHALL HAVE A COMMON SUCTION LINE. SUCTION
minutes VENT LINENTO DUAI,� GRATES MAY BE USED IF APPROVED AT A MAXIMUM 110
GRA
gprn MAIN DRAINS GRADE OF 131 FPS AND THE SUCT10N PIPING IS RECESSED 1.4
FROM THE GRATE THE DISTANCE EQUAL TO THE
SUCTION PIPE SIZE. IN ADDITION A SAFETY VACUUM 0
VENT DETAEL RELEASE SYSTEM MAY BE INSTALLED. THIS MAY
CONSIST OF AN AIR RELEASE SYSTEM. THE VENT 0
(Optie.81) X"- 1. P-4
PIPE SHALL BE TIED TO THE MAIN DRAIN LINES.SIZED 4-1
THE SAME AS THE MAIN DRAIN SUCTION LINE WITH A
MAXIMUM LENGTH OF VENT PIPING TO BE 30.THE
VENT PIPE WILL BE ELBOWED UP AND OVER WITH A
GRATE FOR PRO'MCTION AND LABELED'SAFETY VENT'
MAIN DRAINS AS OF 12-19-09 ANWOR'SAFETY VENT LINE*
ANSItASME A 112.19.9-2007 SKIMMERS DO NOT REQUIRE PROTECTION AND
MUST BE DESIGNED FOR A MINIMUM 25 gprn.
THE FOLLOWING SHALL BE LABELED WrI`H
LABEL MARKER TAPE AT THE FILTER LOCATION,
PO()L PIPES,VALVES,PUMP(S)OFF-WITCH
IT HAS BEEN CERTIFIED TH, -ESE DESIGN
MIN GRATE OPEN AREA FLOW/17.9 REQUIREMENTS ARE IN COMPLIANCE WITH THE
FOR VELOCITY 6*/SFC FLORIDA BUILI)ING--ODE R4101,424.2-20 10,ANSUNSPI 3,
ANSI/NSPI4,ANSIA-"-h' A", ?1�SP?6.ANSl,A.PSP7AN`D
CLEANER ANSi/APSP 15
LINE.
UPTIONAL)
EQUIPMENT RESIDENCE ISLAND POOLS
LOCATION
FLOWTHRUSPA
NO SKIMMFA SKIMMER REQUIRED
TYPICAL G1.F'Ok IV FOR SPA WITH
SKIMMER REBAR.VOUT Wfrf I INDEPENDENT
I I CU TO PUMP FILTRATION SYSM-M
OPT]
DNAI, Df�,;(%NNI
OFTIONAL 12V LIGHT
W/TRANS.-Y,-BRASS RAIL OPTIONAL
OR PVC(SEE NOTES)
NO LIMITATIONS TO
0 Ei
DUAL MAIN DRAINS SHAPE EXCEPT FOR
REQUIRED(TAMPER DIVNG
im, PROOF/SFE NOTES)
STEPS OPTIONAL
ENTRY REQUIRED
SWIN-OUT OR LADDER (SEE NOTES)
REQUI RED(GR/48 CU) >
RCULATION
WHEREDFPTHOVER CI
5-DFEP(SEE NOTES) LINE
VENT
"It.Of"TIONAL- LINE >
GENERALPOOLPLAN
%1' 1. GENERz
2'-9"Min.EXCEPT FOR.
SLOPING ENTRIES.4'.0'Max. SEE NSPI 5 RE-
HANDHOLDS
SAMPLE ONLY.EACH APPLICATION,
WATER BE BASED ON A Toi'AL DYNAM
LINE
EXCEP'TION:ROPE AND
FLOATS INSTALLED IF 11"Max kictmine Systern Flow Rate:
LESS TILIIN 4*-6" Radius 14 M inimum Flow Rate Required:35glun per skimmer
7Max Pool Volume:_sq.fl x__avc depth x'!
110'wai Ttmnover Time in Hours: bouts x 60 minthr
3 Flow Pate: ____gallons/ minutes
PIPE SIZING CHART(MAXIMUM)
S'Mia,TO SLOPE CHANGE PIPE SUC*nON PRESSURE
POOL SECTION DETAM 16. 35 GPM 65 GPM
2' 60 105
SH2836,6-2"? Y4.= 2)5 90 147
1 35 230
FOR BONDINGA.ND GROUNDING SYSTEMS FOR SWIMMING POO",THE USE OF AN 4 235 396
UNDERGROUND BONDING CONDUCTOR MADE OF 83 AWG.BARE SOLID COPPER WIRE
BURIED TO A MINIMUM DEPTH OF 4 INCHES TO 6 INCHES BELOW"GRADE.AND 13 TO FCR POOLS WITI I VOLUME-15.000 GAIS
24 INCHES FROM INSIDE WALL OF A SWIMMING POOL OR SPA.IS DEEMED A
PERMISSIBLE ALTERNATIVE OR EQUIVALENT TO COMPLIANCE WITH s 680.26(c)OF THE ?(AtP HAYWARDSPWI0XI52AZ. 0")L)
NATIONAL Et,ECTRICAL CODE HAYWARD SP301 SX202AZ(SPA)
MAL SPEED PUMPS
TIURNOVER PATE-6 HOURS-360 MINS,
PAVERS OR OR DUAL SPEED PUMPS Aft
FOOTING 4-DECK 2,5W VARIABLE
DECK FINISH "UIRED IF THE PUMP EXCEEDS I HP,
OPTIONAL ps,(Mitt.)CONC PEP.CONTP ACT PLUMBIN'G WILL BE DESIGN FOR TI III MAX
W/FIBER MESH (NON-SLIP) R-OW OF TI W PUIMP REFER TO TDH
CYCCULATIONS FOR VARIABI FOR IX 1AI
.............................. FU.Tl-'R. IIAYWARDC1200.120OPMCAPACITY
..........
OR HAYWARD C 1750,175 GPM
14 POOL VNIS.11
PER CONT'RACI
VAIN DRAIN.CUSTOM MOLDED 25507-IW-010
8"X 3*FOOTING BEA M&7"BAR
W/(2)03 BARS OPTIONAL CI.EANER HAYWARD VAC LOC
OR(1)H5 BAR 4 FINISH)r Vf�wTSCREEN WATERWAY 640-231XV
6 MARCIE OR
EXMSFP MAINSUCTIONPIPFSIZE'
6"Mw WALL&FLOOR THICKNESS.3,500 psi(MIN)cONC N3 BARS ON AGGREGfiM
12"CENTERS EITHER WAY,TIE ALT.INTERSECTIONS 15"MLN.OVERLAP. SKTAMER SUCTION PIPE SIZE
2"MIN.COVERAGE ON STEEL W/CONC TO ASTM k 13 A 16 ASTM A30-5
Structural subject to suitable soil conditions. Cl,"ANERIVAC PIPE SIZE
POOL/SPA, DECK, BEAM, WALL, FLOOR
y2"
Techko USA-ALARM PROTECTION PRODUCTS - MODEL: S I 87D Page I of I
Quafity�Service,Integrity,Commitment to Excellence Close Window
10, Model: S187D -SAFE POOL
One unit per single entrylopening(and/or with its screen by using the second set of sensors).
Can not be used for 2 windows next to each other.
Magnetic sensor entry alarm
"Always on"alarm protection
Adult pass-through auto reset button
High output I 10-115 dB alarm
Watertweather resistant housing
Magnetic sensor for additional door/screen door
Low battery LED display
CONTAINER: Additional pass-through button for delayed entry from either side door or fence
20 FT:9,600 pcs.
40 FT: 19,680 pcs. Intended for interior or exterior use
40 HQ:22,896 pcs.
9V battery operation(not included
UPC Barcode:014575 18701 1
Pool Guard Alarm USA Patent No.5,473,310 and No.6,727,819
ETL Approved under UL 2017 Standards!
www.tachkomaid.com I Office Products(888)883-2466 1 Security Products(949)380-7300
http://techkomaid.com/security/Pool/S I 87D.html 7/14/2014
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building DeDartment.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 A
Phone(904)247-5826 - Fax(904) 247-5845
E-mail: building-dept@coab.us L Daterouted:
City web-site� http://www coab.us
APPLICATION REVIEW AND TRACV'YING FORM
Property Address: D !nt review �equlred Y -No
Applicant: anniin.. Zoni
5 rnintustrator
Project: ublic Wor
7--
blic; Ufilltie�s
Public Safety
Fire Services
Review fee Dept Signature
Other Agency Review or Permit Required Review or Recei . Date
of Permit Verifiee
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
[]Denied.
Reviewing Department First Review: [qApproved.
(Circle one.) Comments:
G9D
PLANNING &ZONING Reviewed by: Date: 9—
TREE ADMIN.
Second Review: FlApproved as revised. DZZ
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: OApproved as revised. F-]Denie(
Comments:
Reviewed by: Date-
Revised 05/14/09
City of Atlantic Beach
APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 H
Phone(904)247-5826 - Fax(904)247-5845
Date routed:
E-mail: building-dept@coab.us
City web-site: http://www-coab.us
APPLICATION REVIEW AND TRACV'�`ING FORM
Property Address: C�12 ds� D entreview required
uildin
Applicant: ?6,0 /S
ministrator
Project: Al Public W. r.
blic Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review o Date
of Permit Verified_-�'-�-y
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other
APPLICATION STATUS
Reviewing Department First Review: Approved. []Denied.
(Circle one.) Comments:
- F 1 4;&.�aC60 44r4 et 'l4ey,-,C e 4. 6a
BUILDING re 4,010,-6 40 tKf I C 44'6j% W44e oo
PLANNING &ZONING
e
viewed by:-x Date: V-1
TREE ADMIN. Second Review: []Approved as revised. FIDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by:____ Date:
FIRE SERVICES Third Review: DApproved as revised. nDeniedl.
Comments:
Reviewed by: Date:
Revised 05/14/09
City of Atlantic Beach
APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5 45 JUL 17 20114
E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACV.11SIG FORM
D t _�_(_es N o
Property Address: ")eS-d Zwlv A(t4' g4wr_tmen review required
-ouilding D —
Applicant: -1:1-a–nning &Zo_n�i�
I ItM A-a-ministrator
Project: ublic Wor
7 17"
-
ublic Wor
Public Safety
Fire Services
.Review fee Dept Sig'naturea_
Other Agency Review or Permit Required Review or Recei Date
of Permit Verifiee�
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other.-
APPLICATION STATUS
Reviewing Department First Review: Approved. []Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed b Date:-7-9/4"K
TREEADMIN_
Second Review: nApproved as revised. nDenied.
IWN Comments:
UTIL
C
P*BLI SAF�ETY/ Reviewed by: Date:
FIRE SERVICES Third Review: [JApproved as revised.
[]Denied
Comments:
Reviewed by: Date:
Revised 05114/09
City of Atlantic Beach APPLICATION NUMBER
(To be assigned by the Building Department.)
800 Seminole Road _-CEIVET ,
Building Department
Atlantic Beach, Florida 32233-5445 JUL, 17 2014
Phone(904)247-5826 - Fax(904) 247-�845 Date rLouted�: ����...
E-mail: building-dept@coab.us
City web-site: hftp://www.coab.us by:
7L.
APPLICATION REVIEW AND TRACQ�'JNG FORM
Property Address: C=)d-'5-d uil tapent review required _��_es No
f2 ipLo-2,
Applicant: PTainning &Zoni
trator
Project:
s
#"s
ublic Uttilitie
Publkc-Safety
Fire Services
A_(L
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Recei,; Date
- of Permit Verified-Sy
Florida Dept.of Environmental Protection
Florida Dept. of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other
APPLICATION STATUS
Reviewing Department First Review: I*pproved. []Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by. _�a�e_-7
TREE ADMIN. Second Review: nApproved as revised. RDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ElApproved as revised. OlDenied.
Comments:
Reviewed by: Date-
Revised 05/14/09
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00001129 Date 9/04/14
Property Address . . . . . . 2050 BEACH AVE
Application type description SWIMMING POOL/SPA
Property Zoning . . . . . . . RES GEN MF DISTRICT
Application valuation . . . . 35000
----------------------------------------------------------------------------
Application desc
NEW POOL
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
CDL AB LLC ISLAND POOLS,LLC
335 11TH ST 1546 LINKSIDE DR
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 334-5421
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL PERMIT
Additional desc . .
Sub Contractor . . HAZOURI ELECTRIC, INC.
Permit Fee . . . . 95 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 3/03/15
----------------------------------------------------------------------------
Special Notes and Comments
Full right-of-way restoration, including sod, is required.
Full erosion control measures must be installed and
approved prior to beginning any earth disturbing
activities . Contact Public Works (247-5834) for Erosion
and Sediment Control Inspection prior to start of
construction.
2010 FLORIDA BUILDING CODE, 2008 NATIONA1 ELECTRIC CODE
REQUIRED INSPECTIONS :
*POOL STEEL
*ELECTRICAL GROUNDING AND BONDING
*FINAL (PUMPS MUST BE RUNNING FOR FINAL)
SWIMMING POOL SAFETY INSPECTION REQUIRED
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE ELEC DCA SURCHARGE 2 . 00
STATE ELEC DBPR SURCHARGE 2 . 00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 95 . 00 95 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 99 . 00 99 . 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 13EACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK$
NEW SERVICE El Overhead Underground Underground up Pole
DResidential(Main)Service
00-100 amps 0 101-150amps D 151-200amps Fl_ai-nps of Meters
0 Commercial(Main)Service
LIO-100 amps 0 101-1 50amps F1 151-200amps L 1__ amps OCT Service amps
Conductor Type Size
LIMulti-Family(Main)Service
00-100 amps 0 101-150amps R 151-200amps 11_� - I 111ps # of Unit Meters
OTemporary Pole 0 amps
SERVICE UPGRADE 0_____amps P CT Service— amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.) I
F100amps IJI50amps L1200amps 11 amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 3 1-1 00amps 10 1-200amps
Appliances: 0-30amps 3 1-1 00amps 101-200amps
A/C Circuits: 0-60amps 61-1 00amps
Heat Circuits: # circuits @_____jw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
OSwimmingPool OSign D Smoke Detectors_Qty OTransformers___ KVA FjMotors lip
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty_volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
[]Replace Burnt/Damaged Meter Can FI Safety Inspection OPanel Change OOH to UG
0 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 a Phone Number 2 Fry- T
Electrical Company t! Office Phone o? Fax
Co. Address:,?. city.� eLLlr.
State Zi-D Vo
License Holder(Print): Qo �4&'Z V-1 State C.5ai,4eati6h—/Registration#
Notarized Signature of License Holder
Before me this day of 20
Signature of Notary Public