1515 OCEAN BLVD TEMP POLE (2) It Is CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00003767 Date 12/04/13
Property Address . . . . . . 1515 OCEAN BLVD
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0 ---------------
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Application desc
TEMP POLE 50 AMPS 240 VOLTS SINGLE PHASE
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Owner Contractor
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OSSI DEVELOPMENT, INC. KNIGHT ELECTRIC LLC
1112 THIRD STREET, SUITE 4 908 11TH AVE S
ATLANTIC BEACH FL 32233 JACKSONVILLE BEACH FL 32250
(904) 247-9884
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Permit . . . . . . ELECTRICAL PERMIT
Additional desc . .
Permit Fee . . . . 90 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 6/02/14
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Other Fees . . . . . . . . . STATE ELEC DCA SURCHARGE 2 . 00
STATE ELEC DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 90 . 00 90 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 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
800 Seminole Rd, Atlantic Beach, Fl, 32233
Ph (904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: /57 5'_ Oc4w Islud. PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS -0 Amps �20VOLTS PHASE
VALUE OF WORK$
NEWSERVICE 0 Overhead Underground Underground up Pole
Residential(Main) Service
LIO-100 amps I-A01-150amps E 151-200amps amps # of Meters
'J Commercial(Main) Service amps
I L 11 0-100 amps L 110 1-15 Oamps L i 151-200amps amps FCT Service
Conductor Type Size
I JMulti-Family(Main) Service
am #of Unit Meters
jO-100 amps El 101-1 50amps I "151-200amps ps
[Vfemporary Pole F_0 _amps
SERVICE UPGRADE E—amps FI CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
F'100amps `150amps 11200amps 'L-I_amps ECT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 3 1-I 00amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
�i Swimming Pool 1-1 Sign [i Smoke Detectors___Qty i �Transformers KVA PMotors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty_volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
L Replace Burnt/Damaged Meter Can U Safety Inspection [ !Panel Change [-I OH to UG
L!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 Phone Number
Electrical Company J�.4- r accra-c- LL(— Office Phone Fax
eT,
Co.Address: 1v City Jo7L ak State 0 zip
License Holder(Print): 'STtjY__ State Certification/Registration 4 EP13012121
Notarized Signature of License Holder
Before me this day of 20
Signature of Notary Public