255 PINE ST TEMP POLE CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
r ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
JF31>`'
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
30B INFORMATION:
Job ID: 15-ELEC-2063
Job Type: ELECTRIC ONLY
Description: temp pole 40 amps
Estimated Value:
Issue Date: 9/1/2015
Expiration Date: 2/28/2016
PROPERTY ADDRESS:
Address: 255 PINE ST
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: KNIGHT ELECTRIC LLC
Address: 908 S 11TH AVE QA MARK STEVEN KNIGHT
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
�^ Ph(904)247-5826 Fax(904) 247-5845 �r
JOB ADDRESS: 7 /l/t,,ryrt.�~ PERMIT# �)
,IEA INFORMATION REQUIRED ON ALL PERMITS r- 0_AMPS VOLTS PHASE
VALUE OF WORK S
NEW SERVICE ❑ Overhead ❑ Underground EDUnderground up Pole
-2 Residential(Main)Service
..,0-100 amps ::I 101-150amps 151-200amps amps #of Meters
.iCommercial(Main) Service
110-100 amps 7101-150amps -115 1-200amps I I amps rICT Service amps
Conductor Type Size
I ]Multi-Family(Main)Service
[10-100 amps U 101-150amps 1151-200amps 1 i amps # of Unit Meters
*Temporary Pole 1 1 VQ_amps
SERVICE UPGRADE I amps CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
X1100 amps ; !1 Mamps 7200amps I I amps L_ICT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUT$,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 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
L..:Swimming Poot f : Sign flSmoke Detectors_Qty F;Transformers KVA I iMotors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK S
REPAIRS/MISCELLANEOUS
.Replace Burnt/Damaged Meter Can i :Safety Inspection I I Panel Change I.-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. Ali provisions of laws and ordinances governing this work will be complied with whether
specitied 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 kM �� Phone Number
Electrical Company pA r il-C , -C G Office Phone V7— Fax 074ff.7
Co. Address: fir` City State r/, zip_ ZZ IV
License Holder(Print): State Certification/Registration # WAC"
INotarized Signature of License Holder
SHERM L STEPP Before me this day of
Notary Public-State of Florida
My Comm.Expires May 31,tot s Signature of Notary public
- a€.•' Commission#EE 203994
'I`'' o,`„�'P Bonded Tnrouo National Notary Assn.