720 W 14th St - Electric only Temp Pole 'r !. --1J`J r
' � s CITY OF ATLANTIC BEACH
.� ) 800 SEMINOLE ROAD
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,_„,,,,,____________y 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: 16- ELEC -64
Job Type: ELECTRIC ONLY
Description: TEMP POLE
Estimated Value:
Issue Date: 1/8/2016
Expiration Date: 7/6/2016
PROPERTY ADDRESS:
Address: 720 W 14TH ST
RE Number: 171050 -0004
PROPERTY OWNER:
Name: CONLEY ET AL, MICHAEL
Address: 720 W 14TH ST
GENERAL CONTRACTOR INFORMATION:
Name: MARCO ELECTRICAL CONTRACTORS
Address: 720 MILL CREEK RD QA BENJAMIN EDWARD SMITH
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 1 60 EC `(v 4_
JOB ADDRESS: - 1 i
a 4 y
�� Q'� ��S l PERMIT # U
JEA INFORMATION REQUIRED ON ALL PERMITS ca30 AMPS VOLTS PHASE
VALUE OF WORK $
NEW SERVICE n Overhead Underground Ell Underground up Pole
Residential (Main) Service `
0 - 100 amps 101 150amps 151 200amps - -- amps # of Meters 1
Commercial (Main) Service
0 - 100 amps 101- 150amps 151- 200amps amps CT Service amps
Conductor Type Size
Multi Family (Main) Service
0 amps 101 150amps 151 200amps amps # of Unit Meters
Temporary Pole 6 0 amps
SERVICE UPGRADE amps CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.)
10 amps 150amps .200amps amps CT 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
Swimming Pool Sign 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 Safety Inspection Panel Change 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. 1 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 lb , V ■ O : V9) t�>Y S Phone Number
Electrical Company 1� �-' • , ' 't : Office Phone ?-I T13 -3 Fax_9± �- 1 _ a1
Co. Address: r l� M \ \ irsQ. k. __ - - City c SQ_)m State Zip 3a<5. t )
License Holder (Print): _w,; a . . Srn State ,erti 'cation/Registration # \ 3O0 -x,15
Notarized Signature of License Holder
EXPIRES: December 1 1, 2018 � y
� Sworn and subscribed before i e this 4� day of rnv,cz 20.1(4
Y BONNELL W CRAIG
M Y COMMISSION a FF 1 Signature of Notary Public ),t -k �, ''`� �� D D
+, t w �` 2018