392 11th St 2014 Temp Pole . , CITY OF ATLANTIC BEACH
',.iJ 800 SEMINOLE ROAD
1 ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 14-ELEC-454
Job Type: ELECTRIC ONLY
Description: temp pole
Estimated Value:
Issue Date: 11/18/2014
Expiration Date: 5/17/2015
PROPERTY ADDRESS:
Address: 392 11TH ST
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: ERICKSON ELECTRICAL CONTRACTOR
Address: 2807 ST JOHNS QA FRANK W ERICKSON
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Temporary Electrical Service $35.00
Trade Permit Base Fee $55.00
Total Payments: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
/ ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
�j 800 Seminole Rd, Atlantic Beach,FL 32233
Ph(904)247-5826 Fax (904) 247-5845 �L
Jolf ADDRESS: 1 ll `I'� J�-M 1��C � � �1�I rERMIT
JEA INFORMATION REQUIRED ON ALL PERMITS U_AMPS VOLTS ( PHASE
VAL UE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
❑Residential(Main)Service #of Meters
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps
❑Commercial(Main) Service
❑0-100 amps 0101-150amps ❑151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
Mu i-Family(Main)Service
-100 amps p 1 1-150amps [I151-200amps ❑ amps #of Unit Meters
Temporary Pole ❑amps
SERVICE UPGRADE [l amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps ❑ amps ❑CT 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 E]Safety Inspection '.-,Panel Change OH to UG
Fj 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.
Phone Number tA ��p
Property Owners Name
Electrical Company = Office Phone
l �-Q 00( Fax v
Co.Address: C t Cit
`,y y �v State� Zip
VNotaLicense Holder(Print): State Certification/Registration#V—
Notarized
rized Signature of License Holder