1691 Atlantic Beach Dr - Elec Only Temp Pole 0 1A41-1 :
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JfY
:, CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
J v 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 -45
Job Type: ELECTRIC ONLY
Description: TEMP POLE
Estimated Value:
Issue Date: 1/7/2016
Expiration Date: 7/5/2016
PROPERTY ADDRESS:
Address: 1691 ATLANTIC BEACH DR
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.
2 ELECTRICAL PERMIT APPLICATION
.� l3 CITY OF ATLANTIC BEACI3
It -EXEC -4.5
800 Seminole Rd, Atlantic Beach, FL 32233 .
Ph (904) 247 -5826 Fax (904) 247 -5845 -
IOB ADDRESS: Ilo / Mics4 AZ. / 4.- (-I' lit-- PERMIT # t S - Cfi< - 2 - 4 7
FEA INFORMATION REQUIRED ON ALL PERMITS ZZW AMPS Z - ‘ 11' . 7 VOLTS / PHASE
VALUE OF WORK $ `-
ktEW SERVICE n Overhead `—' Inderground (lJ Underground up Pole
=Residential (Main) Service
-0 -100 amps E 101- 150amps _x'51- 200amps ._ amps # of Meters
Commercial (Main) Service
:10 -100 amps :- 101- 150amps 1151- 200amps 1 amps - CT Service amps
Conductor Type Size
Multi- Family (Main) Service
-0 -100 amps 101- 150amps _ 151- 200amps li amps # of Unit Meters
.Temporary Pole Z✓ 6 amps
iEIIVICE UPGRADE = amps E7 CT Service amps
■IEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.)
1100 amps _ 150amps 200amps _. amps L CT Service amps
ADDITIONS, REMODY •S 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:
3THER ELECTRICAL PROJECTS
_?Swimming Pool Sign Amoke Detect.. ,, Qty - ?Transformers KVA =]Motors hp
IRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts /amps VALUE OF WORK $
IEPAIRS/NIISCELLANEOUS
7. Replace Burnt/Damaged Meter Can Li Safety Inspection 51 Panel Change 5=011 to UG
.Other:
'ermit 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
ead 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
pecified 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
:onstruction.
'roperty Owners Name _7 t - ac c. S Phone Number
electrical Company M e (..-&.r ( Office Phone KS1 Fax 761 IC & V
7o. Address: ,?2-4/ r,,, , 8c, e- -- c City J✓ State Zip 32 2 Sy
_.i.cense Holder (Print): l_o✓ 6 r�� `. - State Certification/Registration # tZ 0
Notarized Signature of License Folder ,,,„!,,,,, �"" - _iii+- -
1 .��;i'. pie, CHRIS M. THOMAS �� - � ,. Notary Public State of Florida worn and subscribed before me this 5 -- day of _1 t• .r.. . - -
20
Commission # FF 943955
i �
-, a My Comm. Expires Dec 15.2019 Signature of Notary Public ( -- - gyp.,
'' f° lo Bonded through National Notary Assn. 0 � -/ _