1201 Gladiola Street TEMP POLE It r'S \�`1 j-✓ � .
'' J
; , , CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
yr ATLANTIC BEACH, FL 32233
J INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ELEC-2731
Job Type: ELECTRIC ONLY
Description: ELECTRIC - TEMP POLE
Estimated Value:
Issue Date: 11/23/2015
Expiration Date: 5/21/2016
PROPERTY ADDRESS:
Address: 1201 GLADIOLA ST
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: MCCLURE ELECTRICAL CONTRACTORS
Address: 537 N 5TH AVE QA ROBERT MCCLURE, JR
Phone: 904-237-4701 —-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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE wrrn ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904)247-5845 15-ELEC' Z73 (
JOB ADDRESS: `2- o\ GA neo 1 o`h- s-k • PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS \on AMPS 2A-0 VOLTS \ PHASE
VALUE OF WORK$
NEW SERVICE Overhead ❑ Underground ❑J Underground up Pole
❑Residential (Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps [CT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
emporary Pole ❑ ∎•o amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps ❑ amps ❑CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-3 Damps 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
0 L_1Swimming Pool ❑ Sign ❑Smoke Detectors Qty Transformers KVA OMotors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change 0 O 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. 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. /1
Property Owners Name 7 m� iv'n-C Phone Number
Electrical Company '(v\ `C-L 1. E.Ac.<-\lc.%c-' ` Office Phone• LS 1 - +1°1 Fax
Co.Address: IS 2.1 S w-•c.v..•e-s S (�.o'r City ..+�•ou.t.. State r-� Zip '3 Z°3 4-
License Holder(Print): , a . '` .L .,.. State Certificatis •,' -jstration# e.&.000 U t&
Notarized Signature of License Holder -'� — a�
_•'i tsSIOM"e r* e l,R.. l 3 day of 1 O A 0 1_5
.s. ra
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