1780 ATLANTIC BEACH DR TEMP POLE CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
J =� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
'r�J131�r?
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ELEC-1217
Job Type: ELECTRIC ONLY
Description: TEMP POLE
Estimated Value:
Issue Date: 5/28/2015
Expiration Date: 11/24/2015
PROPERTY ADDRESS:
Address: 1780 ATLANTIC BEACH DR
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: AGGRESSIVE ELECTRIC OF FLORIDA
Address:
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACHv 12- 17
800 Seminole Rd,Atlantic Beach,FL 32233 �/
Ph (904) 247-5826 Fax (190_4) 247-5845
.TOB ADDRESS: l� GL �hL 1 1 PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PRASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead [ Underground D Underground up Pole
L1Resideptial(Main) Service artt s # of Meters
—0-100amps ❑101-150am�ps .S 1-200amps C P
Commercial(Main)Service
_'0-100 amps 01101-150amps x 151-200amps ❑ amps OCT Service amps
Conductor Type Size
CMulti-Family(Main.)Service
070-100 amps 7101-150arnps ❑151-200amps Cl amps # of Unit Meters
aemporary Pole K-g
SERVICE UPGRADE o amps CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY S'T'RUCTURES,ETC.)
0100 amps I_"150amps 200amps F _amps 0 C Service _ amps
ADDITIOiNS,REMODELS,REPAIRS,BUILT)-OUTS,ACCESSORY STRUCTURES,ETC.
outlets/Switches: 0-30amps 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 ELEC'T'RICAL PROJECTS
❑Swimming Pool Lw Sign ❑Smoke Detectors_Qty ;]Transformers KVA I]Motors bP
FIRE.ALARM SYSTEM (Requires 3 sets of plans) VALUE OF WORK S
Qty volts/amps
REPAIRS/MISCELLANEOUS
i*]Replace Burnt/Damaged Mehr Can ❑Safety Inspection 01'anel Change DOH to UG
Other;
Permit becomes void it work does not commence within a six month periodowork is laws auspennd ied ors abandoned
�inS£this�wark will be compliedmonths, I hereby rtify withtwhctherc
read this application and know the same to be true and correct. All provisions
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 —T 00A. ED(-C�s Phone Number
ffxce Phone - oq q Fax
Electrical Com-pan ^ • � 'L d r`
co. Address'. C ��'°1a
Q �aP l Cid' ?` ---State +-Zyp329%4,--(
License Holder(Print) State Certificatio�n/Registxation#
r
00
Notarized Signature of License Holder 20�
AL Swom an-subscribed before zrte is _ of
Sigzlatu>a of Notary Publi