130 CLUB DR TEMP POLE `S\ CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
J 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-2856
Job Type: ELECTRIC ONLY
Description: TEMP POLE 40 AMPS
Estimated Value:
Issue Date: 12/10/2015
Expiration Date: 6/7/2016
PROPERTY ADDRESS:
Address: 130 CLUB DR
RE Number: 170319-0000
PROPERTY OWNER:
Name: Shields, David
Address: 53 Oceanside DR
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
I Ph (904) 247-5826 Fax (904) 247-5845
JoB ADDRESS: I/ 0 C f u t4 ,t re— PERMIT# r r� 077
JEA INFORMATION REQUIRED ON ALL PERMITS C' AMPS yU VOLTS PRASE
VALUE OF WORK S
NEW SERVICE ❑ Overhead ❑ Underground ❑J Underground up Pole
7 Residential(Mala)Service
[:10-100 amps [:I 101-150amps I 1151-200amps [.I amps # of Meters
i 'I Commercial(Main)Service
1 i0-100 amps F-'101-150amps 1151-200amps amps F]CT Service amps
Conductor Type Size
�-Multi-Family(Main.)Service
1...0-100 amps I !101-150amlps 151-200amps amps #of Unit Meters
'emporary Pole __,y_amps
SERVICE UPGRADE 7—amps I I CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
-.100 amps Cl 150amps 7200amps A amps ' ICT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES, ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps —31-100a.mps 101-200amps
A/C Circuits: �0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
' ISwimming Pool 7 Sign 1.7 Smoke Detectors_Qty , ITransformers_ KVA EMotors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VAL UE OF WORK S
IREPAIRS/MISCELLANEOUS
7Replace Burnt/Damaged Meter Can []Safety Inspection IPanel Change F 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 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. /
Property Owners Name r (r Phone Number
Electrical Company Nc it Ll ctie(G- Ll-G- OfficePhone 21/-j W Fax ?Y7-W7
Co. Address: S /� 3� City airy iO--k State fl Zip 72 2fV
License Holder(Print): Cn—, vi State Certification/Registration# Fe"130(25"29
Notarized Signature of License.9older
SHERRI L.STE7,'2
efore me this r day of
Notary Public State
•_My Comm.Expires Maignature of Notary Public .
commission#EE Sonded Through National