328 5TH ST TEMP POLE PERMIT S
CITY OF ATLANTIC BEACH
j 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-1651
Job Type: ELECTRIC ONLY
Description: ELECTRIC-TEMP POLE
Estimated Value:
Issue Date: 7/21/2016
Expiration Date: 1/17/2017
PROPERTY ADDRESS:
Address: 328 5TH ST
RE Number: 169834-0000
PROPERTY OWNER:
Name: GOODLING, LOUISE O
Address: 328 5TH ST
GENERAL CONTRACTOR INFORMATION:
Name: KNIGHT ELECTRIC LLC
Address: 908 S 11TH AVE OA 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.
CPERMIT
ATLANTIC BEACH
RECEIPT
PERMIT DESCRIPTION: ELECTRIC-TEMP POLE ?NVD
PERMIT NUMBER: 16-ELEC-1651 I0
ADDRESS: 3285TH ST P,Y�NjtCBEPCH �
OWNER: 0
DATE ISSUED:
FEES DUE:
State Elec DBPR Surcharge $2.00
CRY OF ATLANTIC BEACH
000 SEIANOIE RD
State Elec DCA Surcharge $2.00 ATLANTIC BEAC,ff.32233
0711/2016 14:76:11
Temporary Electrical Service $35.00 CREDIT CARD
VISA SALE
Trade Permit Base Fee $55.00 GRD n %8%ARAXRIIXRII0671
INVOICE 0007
SEQ b: 0004
Oa41t N: 000362
Totals: AWDYal Cods: 034615
$94.00 Erky ftvi: Maul
Mode: alit
TU kwm: 70.00
Cad Code: M
SALE AMOUNT $N.W
CUSIOF£R COPY
ELECTRICAL PERMIT APPI.ICA'fION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach,FL 32233 Cc,
Ph(904)247-5826 Fax (904)247-5845
JOB ADDRESS: 3�S S" PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS )qo vOLTs PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground D Underground up Pole
OResWential(Main)Service
❑0.100 amps C101-150amps 0151-200amps . C amps #ofMetets
UCemmercial(Main)Service ---"
170-100amps 1101-150amps 13151-200amps LI amps OCT Service_amps
Conductor Type - Size
OMalti-Family(Mab,)Service
100 amps 0101-150amps O 151.200amps CI amps #of Unit Meters
ffTempormy Pok O—!0—amp8
IERVICE UPGRADE O-------amps CI CT Service_amps
]EW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
11100ampa ❑150amps 0200amps ❑ amps OCTService_amps
J)DITIONS,REMODELS,REPAIRS,BUMD-OUTS,ACCESSORY STRUCTURES,ETC.
Ormlewswitches: 0-30ampa 31-100amps 101-200amps
Appliances: 0-30amps _ 31-1004mps 101-200amps
A/C Circuits: 0-60amps ^61.100amps
Heat Circuits: # circuits Q kw
Number of Lighting Outlets, Including Fixtures:
THER ELECTRICAL PROJECTS
OSwimming Pool 17 Sign OSmoke Detactors_Qty OTrsnsfonners KVA OMotors_,,,_hp
IRE ALARM SYSTEM (Requires 3 sets of plans)
Qry_volts/amps VAL UE OF WORK$
EPAIRS/MISCELLANEOUS
OReplace Burnt/Damaged Meter Can O Safety Inspection OPanel Change OOH to UG
❑ower:
mit becomes void if work does not ce nmence within a six month period or Work is suspended or abandoned for six months. I hereby certify that I have
d this application and know the sorra to be true and correct. All provision,of laws and ordlaances governing this work will be complied with whether
;cifiad or not. The permit does not give authority to violate the provisions of any other irate or local law regulation construction or the perfomwnce,of
naoction.
3perty Owners Name PQ ` Phone Numb"
�ctriml Company W44jr I L d— Office Phone ZqA-11%4 Fax
. Address: , 9t7r 11w hoE City T&L 1 1, Stater/ Zip TZZfb
sore Holder (Print): ✓4 11f— State Cettification/Registration# EL1761252)
Tari ed Si nature o License Holder
ps,,7t saw fore me this�r day of L 20
NaWy wane•aeon a inllda
eai""l"u"a i<MOgt ignattlre of Notary Public
. ...f ter comm.E*m ate 31.rots 7 704 :rte,r—