42 11th st NEW ELEC SERVICE AND TEMP POLE JA r >j fj��e
:� CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
-- `` ..., ._ _ e ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
-4 0111S ) .
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 16 -ELEC -1053
Job Type: ELECTRIC ONLY
Description: NEW SERVICE 300 AMPS
Estimated Value:
Issue Date: 5/5/2016
Expiration Date: 11/1/2016
PROPERTY ADDRESS:
Address: 42 11TH ST
RE Number: 170269 -0000
PROPERTY OWNER:
Name:
Address: 42 11TH ST
GENERAL CONTRACTOR INFORMATION:
Name: LORE ELECTRICAL CONTRACTORS
Address: 210 N ROSCOE BLVD QA MICHAEL LEE LORE
Phone: - -
FEES:
Trade Permit Base Fee $55.00
State Elec DCA Surcharge $2.00
State Elec DBPR Surcharge $2.00
New Single Family Electrical $90.00
Total Payments: $149.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION /n� ■
CITY OF ATLANTIC BEACH ' �v 3
800 Seminole Rd, Atlantic Beach, FL 32233 ��
Ph (99004) 247 -5826 Fax (904) 247 -5845 I v
JOB ADDRESS: ''/z /7 7/ c772.67 PERMIT #
JEA INFORMATION REQUIRED ON ALL PERMITS ill ° AMPS 2 Vt° VOLTS / PHASE
VALUE OF WORK $ 30, a79 a
NEW SERVICE ❑ Overhead I Ll" Underground nT Underground up Pole
❑ Residential (Main) Service
E] 0-100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Meters
❑ Commercial (Main) Service
00 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi - Family (Main) Service
El 0-100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Unit Meters
❑ Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUUTURES, ETC.)
❑ 100 amps ❑ 150amps ❑ 200amps 3P-0 amps El 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. 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.
Property Owners Name j r 1? / Phone Number
Electrical Company /J,ticig /- Ctr s- Office Phone , i9' 17? / /Vy Fax 373 96 /f
Co. Address: . o f 1 3 J / / , - Citygl a i i State %. Zip 3 2.&i-
License Holder (Print): A9 G / J• L0 - ,tate Certification /Registration #%3r • Naar' ' i • nature of License Holder � ` / ■ /
?o `"Rrn% Notary Public State of Florida ' ∎ ore me this _ d- , of � �` ' , 20 20 /6 ----
.s :. rey L Graham II q` ti''r Commis +on F y �� i _ ir _ •
�avwF+ Expires 02!14/204F 086990 5 • nature of Notary Public
8
III K t o id---
ir 4 S CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
9 ATLANTIC BEACH, FL 32233
sir
INSPECTION PHONE LINE 247 -5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 16 -ELEC -1054
Job Type: ELECTRIC ONLY
Description: 100 AMP TEMP POLE
Estimated Value:
Issue Date: 5/5/2016
Expiration Date: 11/1/2016
PROPERTY ADDRESS:
Address: 42 11TH ST
RE Number: 170269 -0000
PROPERTY OWNER:
Name:
Address: 42 11TH ST
GENERAL CONTRACTOR INFORMATION:
Name: LORE ELECTRICAL CONTRACTORS
Address: 210 N ROSCOE BLVD QA MICHAEL LEE LORE
Phone: - -
FEES:
Trade Permit Base Fee $55.00
Temporary Electrical Service $35.00
State Elec DCA Surcharge $2.00
State Elec DBPR Surcharge $2.00
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 G
CITY OF ATLANTIC BEACH
y r all
r}vv l
800 Seminole Rd, Atlantic Beach, FL 32233 1 ���
Ph (904) 7 904 24 - 5826 Fax (904) 247 -5845 P -0
,,
JOB ADDRESS: f � i ) A
.
/ �� �) %�Z (. PERMIT #
JEA INFORMATION REQUIRED ON ALL PERMITS 760 AMPS 2 )O VOLTS / PHASE
VALUE OF WORK $
NEW SERVICE ❑ Overhead 1 1 Underground I U Underground up Pole
❑Residential (Main) Service
❑0 -100 amps ❑ 101- 150amps ❑ 151 200amps ❑ amps # of Meters
❑ Commercial (Main) Service
00 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps El CT Service amps
Conductor Type Size
❑ Multi- Family (Main) Service
gA amps ❑ 101 150amps LI 151- 200amps ❑ amps # of Unit Meters
emporary Pole 2 amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.)
❑ 100 amps ❑ 150amps 0200amps ❑ amps OCT Service amps
ADDITIONS, REMODELS, REPAIRS, BUILD -OUTS, ACCESSORY STRUCTURES, ETC.
Outlets /Switches: 0- 30amps 31- 100amps 101- 200amps
Appliances: 0- 30amps 31- I00amps 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 11 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 El Safety Inspection ❑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.
Property Owners Name Phone Number
Electrical Company 4 L & / 0,14,4tr - r: C Office Phone Fax
Co. Address: 2/0 N. - UE' / c.. • City State Zip
License Holder (Print): i %'9r/ 4. 1-',2 — State Certification/Registration #
Notari ed Si : nature o License Hol er l - 4 i
:94 Y pV ^ Notary Public State of Fiords TN ore me this d • , of �I1 - 4 /' 20
Shirley L Graham
a ` My Commissi FF 086990 waxer -
Nor of Expires 02!14/2018 S _nature of Not ary Publi
MI <AL06-) !3