395 12TH ST - ELECTRIC TEMP POLE r\J\
f J;
rs f CITY OF ATLANTIC BEACH
(;---. 800 SEMINOLE ROAD
; e ATLANTIC BEACH, FL 32233
/ INSPECTION PHONE LINE 247-5814
Ji�I6r
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ELEC-1487
Job Type: ELECTRIC ONLY
Description: Temporary Pole - 40 amps, 240 volts
Estimated Value:
Issue Date: 6/29/2016
Expiration Date: 12/26/2016
PROPERTY ADDRESS:
Address: 395 12TH ST
RE Number: 171922-0000
GENERAL CONTRACTOR INFORMATION:
Name: KNIGHT ELECTRIC LLC
Address: 908 S 11TH AVE QA MARK STEVEN KNIGHT
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
i
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845 1(0/ — BC `1487
JOB ADDRESS: 39 C" 12'n^ cr PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS t o I PHASE
FO AMPS :, , VOLTS
Y VALUE OF WORK$
NEW SERVICE ❑ Overhead n Underground I U Underground up Pole
DResidential(Main) Service
DO-100 amps ❑101-150amps ❑151-200amps ❑_ amps #of Meters
Li Commercial(Main) Service
❑0-100 amps 0101-150amps 0151-200amps L) amps OCT Service amps
Conductor Type Size
OMulti-Family(Main)Service
00-100 amps D 101-150amps 0151-200amps ❑ amps #of Unit Meters
MIemporary Pole ❑ HQ amps
SERVICE UPGRADE 0 amps 0 CT Service amps
VEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
Cl 100 amps ❑150amps 0200amps 0 amps LI 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:
'THER ELECTRICAL PROJECTS
0 Swimming Pool 0 Sign ❑Smoke Detectors_Qty ❑Transformers
KVA ❑Motors hp
[RE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps • VALUE OF WORK$
EPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection DPanel Change ❑OH to UG
❑Other:
mit 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
I 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
:ified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the perfonnance of
struction. 1 ,
perty Owners Name f(� 6 Y EAD To 2C Phone Number
ctrical Company V/vt5
wt L,,-(..,-0(t, Q. - Office Phone Fax
Address: in /(" /)- 50,1 ,
e City '144, �C1. State aZip 1 72-Cause Holder (Print): JT{✓L ' State Certification/Registration#LI t -7213 DI2S 27
L
arize -. ,,` } _;:R t;' "•"!=.i%e
rq�i.. t
: ,., MY COMMISSION i�FF 924951
',1:4.. Z. EXPIRES:October 6,2oBefs e me this dayof AP
;1 •
,r. Banded Tans Notary Pubic Underwriters ( 1� 20
ignature of Notary Public IIMPAIE , i
/
.„
r S ATLANTIC BEACH
,rW. - ;-, PERMIT RECEIPT
PERMIT DESCRIPTION:Temporary Pole-40 amps, 240 volts 261PERMIT NUMBER: 16-ELEC-1487 SUN 29*\ZK;B-ACH
NI
A 4 ),-
ADDRESS: 395 12TH ST c,\-\\ OF
(‘ ( V
OWNER: `/
DATE ISSUED:
FEES DUE:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Temporary Electrical Service $35.00
Trade Permit Base Fee $55.00 CITY OF ATLANTIC BEACH
800 SEMINOLE RD
ATLANTIC BEAC,FL 32233
06;29,2016 11:39:42
Totals: $94.00 CREDIT CARD
VISA SALE
CARD; XXXXXXXXXXXX0614
INVOICE 0005
SEQ#: 0005
Batch 4: 000347
Approval Code: 003945
Entry Method: Manual
Mode: Onlne
Tax Amount: $0,00
Card Code: M
SALE AMOUNT $94,00
CUSTOMER COPY