587 Beach Ave temp pole 2015 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
> 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: 15-ELEC-19
Job Type: ELECTRIC ONLY
Description: TEMP POLE
Estimated Value:
Issue Date: 1/8/2015
Expiration Date: 7/7/2015
PROPERTY ADDRESS:
Address: 587 BEACH AVE
RE Number: 170157-0000
PROPERTY OWNER:
Name: CRABTREE, RR
Address: 8777 SAN JOSE BLVD
PROPERTY OWNER:
Name: MOQUIN, KIRK &ANNE MARIE,
Address: 2375 S PONTE VEDRA BLVD
GENERAL CONTRACTOR INFORMATION:
Name: TRI COUNTY ELECTRICAL
Address: 11637 E COLUMBIA PRK DR QA KEVIN LEE WEIR
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: $94.00
PERMIT IS APPROVED ONLV IN ACCORDANCE WITH ALL CITV OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: ,5Op?. &-aj A V�-P— PERMIT# 13— 3SO0
JEA INFORMATION REQUIRED ON ALL PERMITS _Z .AMPS VOLTS / PHASE
VALUE OF WORK$
NEW SERVICE ❑ 'Overhead ❑ Underground ❑T Underground up Pole
❑Residential (Main) Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
❑Multi-Family(Main) Service
0-100 amps 0101-150amps ❑151-200amps ❑ amps #of Unit Meters
*emporary Pole 0_6Z_amps L/t,_'_ _"J 7,e
�O
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps ❑ amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-3 Damps 31-l 00amps 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
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans&Fire Alarm Checklist)
Qty volts/amps VALUE OF WORKS
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change OOH 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. jkr-Ot—C,
Property Owners Name / �r� �)m P/6 Phone Number
/ _
Electrical Company 1Y-I CO✓r l 7'ci �/e L. 4 /4r7 I/V Wffice Phone;440 Fax
Co. Address: 1 (0 ] G- CtJ���►.�, a �/'I City C State Zip s �i
License Holder(Print): i\ L- V" ', ' tate Certification/Registration#deF" O 4015700
Notarized Si nature oLic n e der `z'"" �"
TAMMY PALL '
worn and subscribed before me this�_day of n v 20
Notary Public-State of Florida
•: My Comm. Expires Jul 6.2016
Commission # EE 202003 ignature of Notary Public
Bonded Through National Notary Assn.