290 BEACH AVE - TEMP POLE i f
`j;, CITY OF ATLANTIC BEACH
�\ S1'�
800 SEMINOLE ROAD
T)' ;� 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-2618
Job Type: ELECTRIC ONLY
Description: temp pole 60 amps
Estimated Value:
Issue Date: 11/17/2015
Expiration Date: 5/15/2016
PROPERTY ADDRESS:
Address: 290 BEACH AVE
RE Number: 170196-0010
PROPERTY OWNER:
Name: PITLER. ANDY
Address: 273 OCEAN BLVD
GENERAL CONTRACTOR INFORMATION:
Name: ERICKSON ELECTRICAL CONTRACTOR
Address: 2807 ST JOHNS QA FRANK W ERICKSON
Phone: 904-735-9271
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
From:BOSCO BUILDING CONTRACTORS INC 904 241 0326 11/04/2015 12:42 11239 P.005/006
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph (904) 24 -5826 Fax (904) 247-5845•JOB AWR� E`SS: I- 0 -P I PERMIT#
�"Ylo�40 ' ... 2,Z z
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground n1 Underground up Pole
=Residential(Main) Service
F10-100 amps 0101-150amps ❑151-200arnps Ll amps #of Meters
❑Commercial(Main) Service
00-100 amps fl 101-150amps `7151-200amps J amps :CT Service amps
Conductor Type Size
❑M ti-Family(Main Service
0-100 amps 101- 50amps ❑151-200amps U amps #of Unit Meters
,Temporary Pole amps
SERVICE UPGRADE amps : CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
Li 100 amps C 150amps 0200amps i 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
0Swimming Pool ❑ Sign ❑Smoke Detectors_Qty riTransformers 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 UPanel Change DOH to UG
•
C 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. 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 g.7ei V b`.Pfl2 Phone Number
Electrical Company IP g. Office Phone? ( '4"`' Faxj.°
Co. Address: .' I d� 0 k !'. ' I ity 't1kA ?N. State T` Zip7Z �
License Holder (Print): r �� ..tate Certification/Registration#*... 000C;ZO
Notarized Signature of License Holder
L.,ir
,� #�► + + w�t*.�='�.M� Sworn and subscribed before I• this 5 _ day of moo►-. 20/i