601 COASTAL OAK LN TEMP POLE PERMIT s ��rL�l1ju�
CITY OF ATLANTIC BEACH
r) 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-1712
Job Type: ELECTRIC ONLY
Description: ELECTRIC -TEMP POLE
Estimated Value:
Issue Date: 7/28/2016
Expiration Date: 1/24/2017
PROPERTY ADDRESS:
Address: 601 COASTAL OAK LN
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: MCDONALD ELECTRIC
Address: 6915 WEST BEAVER ST QA LARRY BRIAN CARTER
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd. Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845 ,o -CLC— 7
.TOB ADDRESS: 1001 Cor-Sr?-- O� Lf_/ PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VAL UE OF WORK$
NEW SERVICE ❑ Overhead [Underground ❑1 Underground up Pole
-Residential(Main)Service
0-100 amps 101-150amps 151-200amps _ amps #of Meters
-Commercial(Main) Service
_0-100 amps 101-150amps 151-200amps amps _CT Service amps
Conductor Type Size
-Multi-Family(Main)Service
100 amps -101-150amps x:151-200amps amps # of Unit Meters
emporary Pole amps
SERVICE UPGRADE - amps - CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
100 amps ' i 150amps 200amps amps -CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100ainps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ k«-
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
Swimming Pool 7 Sign Smoke Detectors_Qty Transformers KVA Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRSIMISCELLANEOUS
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. 1 hereby certiffi'that I haN e
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 sive authority to violate the provisions of any other state or local law regulation construction or the performance of
construction.
Property Owners Name OL-(- (_'�VU�s Phone Number
Electrical Company I'1'1�l'd c!�� Office Phone 35'�-1y-73 Fax
Co. Address: 32x 1 - �^'� City, j r-)-x State I` Zip '7eO N
License Holder(Print): State Certification/Registration# e2
Notari ed Signature o License o der
..�;�n�s,,� CHRIS M.THOMAS
,' ' ��.-: Notary Public State of Florida �'�' rn and subscribed before me this a e- day of j j l-I 2016
_ Commission#FF 943955
My Comm.Expires Dec 15,tots ignature of Notary Public
"'I4���C,� Bonded through National Notary Assn.