1770 MARITIME OAK DR - TEMP POLE is----/J
CITY OF ATLANTIC BEACH
is — }!
800 SEMINOLE ROAD
\ � ' �; 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-381
Job Type: ELECTRIC ONLY
Description: Electric Only - Temp Pole 30 amp
Estimated Value: $100.00
Issue Date: 2/18/2016
Expiration Date: 8/16/2016
PROPERTY ADDRESS:
Address: 1770 MARITIME OAK DR
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: RIVERSIDE HOMES OF N FL
Address: 414 OLD HARD RD STE 502 MATTHEW ROBERTS
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 �C_��61
CITY OF ATLANTIC BEACH �`-- `
800 Seminole Rd, Atlantic Beach,FL 32233
Ph(904)247-5826 Fax (904) 247-5845
TOB ADDRESS: Ir1 0 , / '/I.4,., 'r J AA( Ip ,'-,: PERMIT# / - $r'.2• /09 ;>
!EA INFORMATION REQUIRED ON ALL PERMITS :570 AMPS 2 (10 VOLTS / PHASE
VALUE OF WORK S 100. W
VIEW SERVICE ❑ Overhead ❑ Underground ED Underground up Pole
:Residential(Main)Service
:0-100 amps ::101-150amps 151-200amps ._ amps #of Meters
`` Commercial(Main)Service
• :10-100 amps ^101-I50amps 2151-200amps =1 amps CT Service amps
Conductor Type Size
`=Multi-Family(Main)Service
_ 0-100 amps 101-150amps _151-200amps amps #of Unit Meters
ETemporary Pole 2 30 amps
SERVICE UPGRADE amps L CT Service amps
htEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
_2 100 amps =]150amps _200amps __. amps LCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
_':Swimming Pool r Sign ::Smoke Detectors Qty ?Transformers KVA El Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
Replace Burnt/Damaged Meter Can -Safety Inspection T'Panel Change DOH 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. //
t�6 ��
Property Owners Name Rt U-v5 f � % �� Phone Number
Electrical Company /Y1 `/)drvJ� £ -c- , t. Office Phone .Sip-5'Y-23 Fax 736'-/y 9Y
Co.Address: 3z-e/ /,--- &CV,,-- City , _./c-Ls State - Zip 5.2 2 S2
License Holder(Print): " C4r S ,,Certification/Registration# /7�
Wiled S azure o,f License of er
e• C22
' ,•,�,�1 P,,,� CHRIS.M. THOMAS 24 1
-�''" Notary Publc State of flogrda iworn and subscribed before me this I6�` day of Erb.,,,,,�
s• ,.1 Commission # Fr 943955 C/ ,
1 �--�. T, My Comm.Expires Dec 15.zo19iignature of Notary Public �! fl ---
4 ' T, '•`' Bonded through National Notary Assn. 0