1823 ATLANTIC BEACH DR - TEMP POLE s �S rL`JrJ��
`s f CITY OF ATLANTIC BEACH
A s) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
—01119
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ELEC-1859
Job Type: ELECTRIC ONLY
Description: ELECTRIC - TEMP POLE
Estimated Value:
Issue Date: 8/16/2016
Expiration Date: 2/12/2017
PROPERTY ADDRESS:
Address: 1823 ATLANTIC BEACH DR
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: RIGHTWAY ELECTRICAL CONT. INC
Address: 3551 S SANCTUARY WAY QA JACOB TODD IANNELLO
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALI. CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach-,-FL 3223--- FF
Ph(904)247-5826 Fax (904)247-5845 { 0 - ` t B59
JOB ADDRESS: 16,23 AT[ANT is /3t40r
QR PERMIT # /G_SFR-ia.3
JEA INFORMATION REQUIRED ON ALL PERMITS Go AMPS popvc, VOLTS 1 PHASE
- VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑J Underground up Pole
0 Residential(Main)Service
00-100 amps 0 101-150amps 0 151-200amps 0 amps #of Meters
❑Commercial(Main)Service
00-100 amps ❑101-150amps ❑151-200amps U amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
Cif:Temporary Pole ly 6,n amps
SERVICE UPGRADE 0 amps 0 CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps ❑ amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-3 Oamps 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 0 Sign 0 Smoke Detectors_Qty ❑Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑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.
Property Owners Name f 4qt"I q,c,fr AVM Er rAI c. Phone Number fro-SS o6
Electrical Company R/6 yf wg y cif fir'"-4( Co#r4A clan/ Office Phone k,-3-t i or Fax k r)•ti o -
Co.Address: 1x243.3 Sr Jor df 04easrq,0( Prcti,y g - City SAE KfnDryict It State rr Zip 322"
License Holder (Print): j4co rAA,,,,acc' State Certification/Registration#
Notarized Signature of License Holder / ,, •-_ Lk-
91�" .;?, IO MINDLEEP FF 924 efore me this 1 (i day of 2 1
�� �,: EXPIRES: t FF 924951
EXPIRES:October 6,2019 j��, t
°,o .,••' Bonded Tin Notary Puerwuodervrtiters Signature of Notary Public • y