121 DONNER RD - ELECTRIC t.
" /4". s\ CITY OF ATLANTIC BEACH
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-1608
Job Type: ELECTRIC ONLY
Description: temporary pole - 40 amps
Estimated Value:
Issue Date: 7/18/2016
Expiration Date: 1/14/2017
PROPERTY ADDRESS:
Address: 121 DONNER RD
RE Number: None
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALI. CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904)247-5845 l b` CI-EC— I of
JOB ADDRESS: f Q l /9�1'i1,1-e 12)2 PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS LA) AMPS D10 VOLTS f! PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
❑Residential(Main)Service
00-100 amps 0101-150amps ❑151-200amps El amps #of Meters
❑Commercial(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps OCT Service amps
Conductor Type Size
DMulti-Family(Main)Service
00-100 amps 0101-150amps 0151-200am ps ❑ amps #of Unit Meters
C temporary Pole ❑ u# amps
SERVICE UPGRADE 0 amps U CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
[1100 amps ❑150amps ❑200amps ❑ amps ❑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 fI Sign El Smoke Detectors_Qty ❑Transformers KVA 0Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
[Replace Burnt/Damaged Meter Can U Safety Inspection [Panel Change JOH 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 ���r CZE- - ( L C-- Office Phone Fax
Co.Address: i� Wi' / 5 vv c�� City JA-Y. l&. State t'l• Zip -3 270
License Holder(Print): rCv 44(Gfot__ State ertification/Registration# L7213otzra3
f o Signature
Notarized License Holder
z
0.* DONNA L BARTLE Before me this I ` day of 20 /6
s+: MY COMMISSION a FF 018392
��a€ EXPIRES:May 14,2017 Signature of Notary Public O�//(4
0et._ Oa-'
i t440, Bonded Thru Public Underwriters
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