604 TIMBER BRIDGE LN - TEMP ELECTRIC POLE 0 LI-VP:rye,
A -41k. A
tr CITY OF ATLANTIC BEACH
4 *If" 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
„.
INSPECTION PHONE LINE 247-5814
ki.D.F119
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ELEC-1959
Job Type: ELECTRIC ONLY
Description: ELECTRIC - TEMP POLE 200 AMP
Estimated Value: $5,000.00
Issue Date: 8/18/2015
Expiration Date: 2/14/2016
PROPERTY ADDRESS:
Address: 604 TIMBER BRIDGE LN
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: GREENSLADE ELECTRIC, LLC
Address: 6 Reid PL
Phone: 386-263-2960
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Temporary Electrical Service $35.00
Total Payments: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL (Try OF ATLANTIC 13EACII ORDINANCES AND TUE FLORIDA
BUILDING CODES.
n �>� L ELECTRICAL PERMIT APPLICATION
�j Z� CITY OF ATLANTIC BEACH
6oLii �� f 1 800 Seminole Rd,Atlantic Beach, FL 32233 Y" e
s
Ph(904) 247-5826 Fax(904) 247-5845 � I 9
JOB ADDRESS: { I m L A,v?Dv-id Or
JE 0 X7190: 4 t 0a n1t ,"i j $4 ",.'t W. . ;Klnl Li 7 �r AM� i 1 X34
VALUE OF WORK$ 5c0o
NEW SERVICE ❑ Overhead Underground ❑T Underground up Pole •
r:)Residential(Main)Service
I'0-100 amps Cl101-150amps 0151-200amps CI amps #of Meters
'..'Commercial(Main)Service
I!0-100 amps 1:1101-150amps 0151-200amps !_i amps i_:CT Service amps
Conductor Type Size
1- Multi-Family(Main)Service
10-100 amps 11101-150amps CI 151-200amps �� amps #of Unit Meters A
s Temporary Pole N to() amps
SERVICE UPGRADE £ amps l.1 CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
r 11 00 amps [I 150amps L1200amps -; amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200anaps
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
U Swimming Pool 0 Sign CJ Smoke Detectors_Qty £]Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
:I Replace Burnt/Damaged Meter Can C;1 Safety inspection I:]Panel Change DOH to UG
Other: too amp l It
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 1 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. 11 tt
Property Owners Name tom[ J Con -rwcv n ,Phone Number
Electrical Company lC& 31.,lrli,L LLC Office Phone b5010 12 ' Fax 2la?-b ,lqw
Co. Address: ?)1\ S La\\ ' k City 'Af\ft1 k. State Zip 62110
License Holder(Print): JaincS y--een_aimos I •C State Certification/Registration#
Notarized Signature of License Hold' _.,.
Be ore me - day of 20
• Signature of Notary Public