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392 11th St new elec service 2015 s, EARLY POWER AGREEMENT & RELEASE _ r CITY OF ATLANTIC BEACH Electric power is requested now under the conditions and terms of this fully executed Agreement&Release Job Address: Permit No. l�� /� � Service Type(Circle One): Overhead Underground We,the undersigned General Contractor and Electrician,understand and agree: 1. "Early Power" is ppurely for our construction convenience, it is not required by Codes and does not substitute for Final Inspections or the C/O (Certificate of OccupancyTMat must be issued before occupancy, and as such is at the discretion of the Building Official. 2. The City of Atlantic Beach will make a special inspection prior to the early power energizing. All rough inspections must have prior Approval,including meter base connections. 3. Occupancy or use of the new construction before a formal C/O constitutes fraudulent use of the early electric service. Such action is expressly prohibited and penalized by The City of Atlantic Beach Ordinances. A violation of this Agreement shall result in a request for prompt removal of electric service after a twenty-four hour notice. 4. "Early Power"release authority is the Electrician and/or the Contractor and must not occur before: a. Equment,devices and fixtures are installed(or blanked off)safely. b. Panelipis complete with breakers and cover,and(labeling required at final inspection). c. Service connection and grounding is complete. d. The electric system has safely passed through electrical check. e. Meter can ispermanently marked with address. f. Temporary address numbers displayed(Permanent numbers are required for C/O). 5. This fully completed form is to be submitted to the Building Department by hand,mail or fax. 6. Future such Agreements will not be accepted from those who violate any one of the above items. 1 CONTRACTOR DATE PRINTNAME ELECTRICIAN DATE PRINT NAME 800 Seminole Road,Atlantic Beach FL 32233 Phone:(904)247-5826 Fax:(904)247-5845 http://www.coab.us revised 01 30 09 CITY OF ATLANTIC BEACH SJ 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-300 Job Type: ELECTRIC ONLY Description: new service Estimated Value: Issue Date: 2/9/2015 Expiration Date• 8/8/2015 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 Trade Permit Base Fee $55.00 New Single Family Electrical $70.00 Total Payments: $129.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ELECTRICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd,Atlantic Beach, FL 32233 _ Ph(904) 47-5826 Fax(904) 247-5845 JOB ADDRESS: " ��I 1. PERMIT# W1 JEA INFORMATION REQUIRED ON ALL PERMITS -7—U0 AMPS VOLTS PHASE VALUE OF WORK$ NEW SERVICE ❑ Overhead Underground OT Underground up Pole ❑Residential(Main)Service E10-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters ❑Commercial(Main)Service ❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps [I CT Service amps Conductor Type Size ❑Multi-Family(Main)Service ❑0-100 amps ❑101-150amps ❑151-200amps LI—amps # of Unit Meters ❑Temporary Pole ❑ amps SERVICE UPGRADE ❑ amps ❑ CT Service amps NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.) ❑100 amps ❑150amps ❑200amps ❑ amps ❑CT 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 [I Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motors hp FIRE ALARM SYSTEM (Requires 3 sets of plans) VALUE OF WORK$ Qty volts/amps REPAIRS/MISCELLANEOUS ❑Replace Burnt/Damaged Meter Can ❑Safety Inspection El Panel Change ❑OH 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. Property Owners Name ^�� l W _Phone Number �� `- V nn �Z i'�ti(1v�CJQ1� 1� I X 1�,�((� Office Phone �A-�� Fax 2A,-�z Electrical Company 1�i � Co.Address: `�7� �U City &� �W Y4A, State Zip License Holder(Print): -�'�`6� Y/r^�� State Certification/Registration Z C) Notarized Signature of License Holder Before me this day of 20 Signature of Notary Public