1889 ATLANTIC BEACH DR TEMP POLE PERMIT 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-1906
Job Type: ELECTRIC ONLY
Description: ELECTRIC-TEMP POLE
Estimated Value: $100.00
Issue Date: 8/22/2016
Expiration Date: 2/18/2017
PROPERTY ADDRESS:
Address: 1889 ATLANTIC BEACH DR
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: MCDONALD ELECTRIC
Address: 6915 WEST BEAVER ST CA LARRY BRIAN CARTER
Phone: -
FEES:
State Elec DBPR Surcharge $2.00
Temporary Electrical Service $35.00
Trade Permit Base Fee $55.00
Total Payments: $92.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
�/f�P�h(904/)�247-5826 Fax(904)247-5845
dos ADDRESS: /991 /T/lcr�-( /3ea- l^ 4-. PERMIT# /b-Srf -fM)
JEA INFORMATION REQUIRED ON ALL PERMITS 3D AMPS 7,'/0 VOLTS PHASE
VALUE OF WORK$ /00 ,00
NEW SERVICE ❑ Overhead ❑ Underground Underground up Pole
71tesidentiel(Main) Service
1.0-100 amps _101-150amps 07151-200amps _ amps #of Meters
-Commercial(Main)Service
...,0-100 amps -101-150amps ❑151-200amps amps -CT Serviceampg
Conductor Type Size
-Multi-Family(Main)Service
0-100 amps 101-150amps ❑151-200amps amps #of Unit Meters
-Temporary Pok C✓ 30 amps
SERVICE UPGRADE --amps - CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
-100amps '1150malps =200amps amps 7CTService 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-I00amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
-Swimming Pool ❑ Sign !.'Smoke Detectors_Qty -Transformers KVA _Motorshp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty_volts/amps VALUE OF WORKS
REPAIRS/MHSCELLANEOUS
Replace Bumt/Damaged Meter Can -Safety Inspection -Panel Change -'AH to UO
Other.
Permit becomes void ifwork does not commence within a six month period or work is suspended or abandoned for six months. I hereby cattily 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 perfommnce of
mnsWaion.
Property Owners Name %0 Cc 6VTt ,,r Phone Number
Electrical Company d1(11^I „ U C6 c r*t Office Phone Fax
Co.Address: 37,(t City Jlp-lic Stated Zip 3Z2S'/
License Holder(Print): LW✓ /3 /a✓'fi✓ State a tion/R gistration# �'ZpUU /74y
fe,jtplder
CHRIS M.THOMAS
e; Notary public State of Flotlaa woman su cribed before me this 21`1 day of Q�... + 201
Commission Y FF 9/J955
• My Comm.Espiras Dec 15,2019 ignature of Notary Public
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Bonded through Nasional tlmay Assn