582 COASTAL OAK LN ' CITY OF ATLANTIC BEACH
f 800 SEMINOLE ROAD
J� — "� 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-1434
Job Type: ELECTRIC ONLY
Description: TEMP POLE 50 AMPS
Estimated Value:
Issue Date: 6/19/2015
Expiration Date: 12/16/2015
PROPERTY ADDRESS:
Address: 582 COASTAL OAK LN
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
Temporary Electrical Service $35.00
Trade Permit Base Fee $55.00
Total Payments: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
From: BUILDING CONTRACTORS INC 904 241 0326 06/17/2015 17:35 1#130 P.001/001
la"*.'
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: 5'Z t Iticp •% i ': i . i ,- PERMIT# 16-C L' J
iv!' , � rAor ; 1 { or .� - 193
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑1 Underground up Pole
❑Residential(Main) Service
0 0-100 amps C 101-150amps X1151-200amps ] amps #of Meters
Commercial(Main)Service
CO-100 amps ❑101-150amps L 151-200amps -1 amps LiCT Service amps
Conductor Type Size
]Multi-Family(Main)Service
100 amps ❑101-150amps L 151-200amps L1 amps #of Unit Meters
emporary Pole amps
SERVICE UPGRADE LI amps C CT Service amps .
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps C200amps ❑ amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-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 ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign (_-!Smoke Detectors Qty CTransformers KVA ]Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ]Safety Inspection 71Panel Change ❑OH to UG
DOther:
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 c t�/'sJ�� Phone Number IA l 1-0X)
Electrical Company ot,A.Cry2 ?i u(- Office Phone 4 1- FaxZ4 -057--EP
Co.Address: to?) {Y t Nt( _ City State A-.( Zip )Z -Z,
License Holder (Print): no___1(5i-c.x.-5 .3,- 2 State Certification/Registration#,1� L'��%j2
Notarized Signature of License Holder `�