266 CAMELIA ST. ELECTRIC JJ �
S� CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J r
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
]OB INFORMATION:
Job ID: 15-ELEC-1159
Job Type: ELECTRIC ONLY
Description: 40 AMP TEMP POLE
Estimated Value:
Issue Date: 5/15/2015
Expiration Date: 11/11/2015
PROPERTY ADDRESS:
Address: 266 CAMELIA ST
RE Number: None
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
PERMI IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDI G CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach,FL 32233
Ph(904)247-5826 Fax (904)247-5$45 r�
JOB ADDRESS: ��C k(, PERMIT#24- 7 9!
VAL UE OF WORK$
NEW SERVICE �Overbend ❑ Underground [ 1 Underground up Pole
Reaid+entittl(Maid)Service
10-100 amps 101-150amps 151.200antps amps #of Meters
Commercial(Main)Service
0-100 amps 101.150amps 15 l-200amp s
Conductor Type Size amps CT Service
amps
_— _
Multi-Family(Main)Service ---"""
`0'100 amps .101-150amps 151- amps amps #of Unit Meters
iTmporary pole _ amps
SERVICE UPGRADE —amps CT Service
amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
100 amps i 150amps 200amps _amps Cl'Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches., 0-30ani s
P 31-1amps 101-10i
Appliances 0.30amps 31-10000amps 101-200am
A/C Circuits:, —0,60amps -" '"-61-I00am s ps
Neat Circuits: # Circuits r7u kw P`
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
Swimming Pool Sign Smoke Detectors_Qty Transformers
KVA 1 Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps_ VALUE OF WORK P
REPAiCt"ISCELLANlEOUS
Replace Burnt/Damaged Meter Can Safety Inspection Panel Change
ON to UG
..Other:
Permit becomes void 1rwork does not commwtcc within a six month pori(J ur work is suspended or abandoned for six months, l hereby certify thst 1 have
read this Wlication and know the stunt to he 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 ol'an)other state or local law rt gelation construction or the ptrfortnanix of
construction,
Property Owners Name Phone Number
Electrical Company w7 Ler tL Lz.7 e(c r Office a Phare
Fax
Ca,Address: /EW:3�� ity2C1 �, C�,�
State �l. Zip 7 P
Lkense Molder(Print): t'G rot.t A I State C.orti fication/Registration# X121 i W 7' 27
Notarized Sienatare of License Holder —W
Before rhe this day of 20
Signature of Notary Pubi' r—
JENNIFER
=�: ►' MY COMMISSION#Ff Ul 14&) �.
EXPIRES:April 24,2017
AF,t; Bonded Ttuu Notary Public underwa(or,