581 TIMBER BRIDGE LN NEW ELEC AND EARLY POWER \ , CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J �r ATLANTIC BEACH,FL 32233
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INSPECTION PHONE LINE 247-5814
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ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
308 INFORMATION:
Job ID: 15-ELEC-2135
Job Type: ELECTRIC ONLY
Description: NEW UNDERGROUND SERVICE - 300 AMPS. 240 VOLTS
Estimated Value:
Issue Date: 9/9/2015
Expiration Date: 3/7/2016
PROPERTY ADDRESS:
Address: 581 TIMBER BRIDGE LN
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: MCDONALD ELECTRIC
Address: 6915 WEST BEAVER ST QA LARRY BRIAN CARTER
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
New Single Family Electrical $120.00
Trade Permit Base Fee $55.00
Total Payments: S179.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233 j 5 - EL cc _z ( 3 5
Ph(904)247-5826 Fax(904) 247-5845
JOB ADDRESS: 58/ 'M i l d E n b✓r c l , 1,4 PERMIT# /S- 5F—P -/900
JEA INFORMATION REQUIRED ON ALL PERMITS ;OD AMPS ?–'O VOLTS / PHASE
VALUE OF WORK$ '(000
NEW SE)VICE ❑ Overhead [Underground ❑J Underground up Pole
'?Residential(Main)Service
`_J0-100 amps [1101-150amps L 151-200amps ;'3K7 amps #of Meters
UCommercial(Main)Service
10-100 amps f l 101-150amps 7151-200amps amps CT Service amps
Conductor Type Size
=Multi-Family(Main)Service
_;0-100 amps r 101-150amps 151-200amps amps #of Unit Meters
:Temporary Pole U amps
SERVICE UPGRADE 7 amps CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
E1100 amps E1150amps 2200amps =. amps ECT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: /Lb 0-30amps 31-100amps 101-200amps
Appliances: It 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: Z— # circuits @ kw
Number of Lighting Outlets, Including Fixtures: `/2
OTHER ELECTRICAL PROJECTS
!Swimming Pool El Sign L Smoke Detectors Qty : Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
Replace Burnt/Damaged Meter Can Li Safety Inspection UPanel Change DOH to UG
ElOther:
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 %aw 6./0 n4e,S Phone Number
Electrical Company M'--f)eNc--ti &Le-tom t `- Office Phone 3S7o-99-73 Fax 736.-/4 d'i
Co.Address: 3v / W• Ja l'i'4 63". City Jew State ( - Zip 3ZZ S/
License Holder(Print): Lek CA/ tate Certification/Registration# 023 174 y
Notarized Signature of License Holder _ dd. `�1 tz..,
i
so P''''' ',„..',. CHRIS M.THOMAS S m and subscribed before me this 8 day of Sep it...1,..._ 20 1)
r 1'.-= Notary Public-State of Florida
` (L-
;,,+ .4 iti .-?My Comm.Expires Nov 1 2,20 3 afore of No Public �.c. ._
'",ryFOC F"oss Commission# EE 144025
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.,* „ *AEA EARLY PowER AGREEMENT & R. LLASI
CITY OF ATL.A.mcxc BEAM
„ t,Ya
Electric power is requested now under the conditions and term of this fully executed Agreement & Release
lab Address: $ s i,,, t '' 64 Lazy,.
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Pernait No. - � : )6/00 Service Type (Cade' One): Overhead ndecgrounci
We, the undersigned General Contractor and Electrician understand and agree:
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1. "Early Power" ispuml y for our consttu lion onvenience, it is n Nuired by Codes and does not
substitute for Ffnalinspections or the C/O Cer % cote of Occupancy rj ' muss be issued before occupancy,
and as such is at the discretion of the Building Official.
2. The Cry of Atlantic Beach will make a special impaction prior to the • ly power energizing. All rough
inspections must have prior Approval, inclCding r base connections_
3. Occupancy or use of the new .cortisiruction before tt formal C/O cord" rtes fraudulent use of the earl
electno service. Such action ss expressly prohibited and r y The City of Atlantic Beach
Ordinances. A violation of this Agreement shall result in a r nest fo. ampt tCmoval of electric service
after a twenty -four hour notice.
4. "Early Power" release authority is the Electrician and/or the Contractor aiad must not occur before:
a. tqamment, devices and fixtures are . installed orb� feed � safely_
b. anell is complete with btealarrs and cover, and (labeling rcgfnrrdaz final inspection).
c.r ervice connection And grounding is complete_
d. The electric system has safely p as��sed throug electrical check.
e. Water can is permanently reared with address.
f. Temporary address numbers displayed Termane= numbers are r+-. uire for C/0).
4
5. This fully completed form is to be submitted to the Building Department ; _ v hand, mail or fax
6. Future such Agreements will not he accepted from those who violate any one of the shove items,
f
CONTRACTOR. �� DA ; a 2. !,0G
PRINT NAME ,or •
4
ELECTRICIAN Adi / /, t e #e5 DATE (`a
PRINT NAME • i i r . -
800 Seminole Road, Atlantic Beachlt 3223' -
Phone: (904)247-5826 Fay {904}247..584S http://www.coabAs revised 01 30 09