457 SAILFISH DR - TEMP POLE �s f CITY OF ATLANTIC BEACH
,, . �� 800 SEMINOLE ROAD
J ' 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-1656
Job Type: ELECTRIC ONLY
Description: ELECTRIC- TEMP POLE
Estimated Value: $1,000.00
Issue Date: 7/22/2016
Expiration Date: 1/18/2017
PROPERTY ADDRESS:
Address: 457 SAILFISH DR
RE Number: 171374-0000
PROPERTY OWNER:
Name: BROWN, BENJAMIN JR
Address: 457 E SAILFISH DR
GENERAL CONTRACTOR INFORMATION:
Name: SCHUMAN ELECTRIC INC.
Address: PO BOX 48171 QA JOHN JASPER SCHUMAN
Phone: 904-737-4040
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: $94.00
I
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND TILE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233 i 6
Ph(904) 247-5826 Fax(904) 247-58451LEC - l S
JOB ADDRESS: 1 1 5a I-�15'1 Thr 1�/e EAST PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS j . AMPS aLI C) VOLTS I PHASE
VALUE OF WORK$ 1606 •00
NEW SERVICE ❑ Overhead _ )Underground ❑T Underground up Pole
❑Residential(Main)Service
00-100 amps 101-150amps ❑151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps FACT Service amps
Conductor Type Size
0 Multi-Family(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
1Temporary Pole ❑ 6 amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps 0 150amps ❑200amps ❑ amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-3 Damps 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
0 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/NIISCELLANEOUS
❑Replace Burnt/Damaged Meter Can 0 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.
1
Property Owners Name ( Od(60n ki I I\t l-k r ' S Phone Number 3 16-I-
Electrical Company U i c C Office Phone 737-yoyo Fax 3q 6o-- 4/16 ti
p Y � man �� � �y � 3 y y
Co.Address: )6 P 'y 0J8171 City j O State ft..Zip 3 22 117
License Holder(Print): (j a h n I U I • - State Certification/Registration# FG )3 066M
Notarized Signature of License Holder
HOLLY MARIE WALOEp worn r. d subscribed before me th• 3 C) day of J OIL/ 2016
`- :-:: MY COMMISSION#EE853737
'1'•4:` . Signature of Notary Public
*,, EXPIRES November 25,2016
(407)398-0153 FlondallotaryService.com