574 Timber Bridge Ln - Electric Only Temp Pole CITY OF ATLANTIC BEACH
• 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: 16 - ELEC -
Job Type: ELECTRIC ONLY
Description: TEMP POLE
Estimated Value:
Issue Date: 1/7/2016
Expiration Date: 7/5/2016
PROPERTY ADDRESS:
Address: 574 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
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 V Lf3' 47
e91IADDRESS: 57y M6,nz i2civ.. 1...N. PERMIT# 1S -5 C 211 To
EA. ]IINFORMATION REQUIRED ON ALL PERMITS 2 0 0 AMPS L`WW VOLTS +-' PHASE
VALUE OF WORK $
EW SERVICE CD Overhead r _
iderground ( b Underground up Pole
Residential (Main) Service
7.0 - 100 amps 101- 150amps '151- 200amps . amps # of Meters
Commercial (Main) Service
70 - 100 amps 7 101- 150amps 7151- 200amps 7 amps , _: CT Service amps
Conductor Type Size
II Multi- Family (Main) Service
__ 0-100 amps ;=101- 150amps 11 151- 200amps = amps # of Unit Meters
:_7emporary Pole 2 30 amps
ERV IC'E UPGRADE _ amps 2: CT Service amps
EW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.)
100 amps 7=150amps J200amps amps LCT Service amps
DDITIONS, 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 @_ ku
Number of Lighting Outlets, Including Fixtures: ..
> r'Is R ELECTRICAL PROJECTS
_'Swimming Pool Sig :oke Detector,. .ty iTransformers KVA LiiMotors hp
'IRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts /amps VALUE OF WORK $
:EPAIRS/IVHSCELLANEOUS
Replace Burnt/Damaged Meter Can _Safety Inspection TIPanel Change C:01-1 to UG
:
- .rmit 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
ad 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
>ecified 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
)nstruction.
roperty Owners Name 7 Phone Number 3.sZe S't/13
.(ectrical Company M L/ 1 IoNC--/u S&cr 2r c Office Phone Az - iv - 23 Fax '796 - I4 &V
'o. Address: 3Zc / 6...J. f ect v 5/. City , State kt Zip 32 25
.icense Holder (Print): 1 ow C t.,-- State Certification/Registration #
/otarized Signature o(License Holder ____
' ,,` PPV84 CHRISM THOMAS S worn and subscribed before me this j . _ ', da y � li h .. ,.-
of
4° -A `c Notary Public - State of Florida ' "� 20 ��
, Commission # FF 943955
Bi ature of Not Public �'/
.,, My Comm. Expires Dec 15. 2019 � � � ( � -.
Bonded Through National Nonai y assn 0