81 5TH ST - ELECTRIC 0 LAN:06
�� 0 .,;s, CITY OF ATLANTIC BEACH
Jiii
800 SEMINOLE ROAD
r„ r' 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-2021
Job Type: ELECTRIC ONLY
Description: temporary pole
Estimated Value:
Issue Date: 9/9/2016
Expiration Date: 3/8/2017
PROPERTY ADDRESS:
Address: 81 5TH ST
RE Number: 170151-0000
PROPERTY OWNER:
Name: HOLMES, HARRIET E
Address: 81 5TH ST
GENERAL CONTRACTOR INFORMATION:
Name: KNIGHT ELECTRIC LLC
, ER13012523
Address: 908 S 11TH AVE QA 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: $94.00
PERNII'I IS APPROVED ONLY IN ACCORDANCE AN II AI.I. MN OF ATLANTIC BEACH ORDINANCES AND TILE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845 t(p^E_L&L -�a
JOB ADDRESS: -, PERMIT# \S D-76 3
JEA INFORMATION REQUIRED ON ALL PERMITS )CXR AMPS a ) VOLTS y PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground nJ Underground up Pole
[Residential (Main) Service
❑0-100 amps ❑101-150amps 6d 151-200amps ❑ amps #of Meters
[Commercial (Main)Service
❑0-100 amps 1-1101-150amps L1151-200amps ❑ amps OCT Service amps
Conductor Type Size
[Multi-Family(Main)Service
100 amps ❑1 }1150amps ❑151-200amps ❑ amps # of Unit Meters
1Temporary Pole ❑ YU amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps II amps L1CT Service 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 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign Li 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 [Safety Inspection C'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 J V a-ko L SrrabCC4' Q Phone Number
Electrical Company 1 ( 1,4----fA c (( Office Phone DWI -9$ 1-.1 Fax -1-1-1-9?k
Co. Address: QX I Ilk- pue . 5 City 3T State L Zip , a E0
License Holder(Print): YV P( u--erN Lsk\'+- State Certification/Registration#5 L36 1a5a�
Notarized-Sigma older
„ . '4'4% SHERRI T
�:; .` ; Notary Public-Stale of floridIBeforer me this day o
Ili •,c My COMM. res May 31,2020 Signature of Notary Public ' /It_b-L?2 e
'''•,°i i,,`` BondedlimotWionai Notary Assn.