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576 Coastal Oak Ln temp pole permit CITY OF ATLANTIC BEACH l 800 SEMINOLE ROAD ii ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 ELECTRICAL PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 IOBINFORMATION: Job ID: 16-ELEC-2231 Job Type: ELECTRIC ONLY Description: ELECTRIC -TEMP POLE Estimated Value: Issue Date: 10/3/2016 Expiration Date: 4/1/2017 PROPERTY ADDRESS: Address: 576 COASTAL OAK LN RE Number: None GENERAL CONTRACTOR INFORMATION: Name: INTEGRITY FIRST ELECTRIC CO Walter Eugene Haynes, EC13003883 Address: 116 SEAGRAPE DR WALTER HAYNES 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: $94.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ELECTRICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd, Atlantic Beach,FL 32233I IW— JOB L Ci _ z Z3 n Ph(904)247-5826 Fax(904)247-5845 C JOB ADDRESS: S 7�0 eoa1k ( Q&k L V� PERMIT# JEA INFORMATION REQUIRED ON ALL PERMITS I C' AMPS Z yU VOLTS I PHASE VALUEOFWOEK$ �� ya NEW SERVICE ❑ Overhead Underground D Underground up Pole [Residential(Main)Service 110-100 amps ❑101-150amps ❑151-200amps ❑ amps # of Meters ❑Commercial(Main)Service ❑0-100 amps 0101-150amps ❑151-200amps ❑ amps ECT Service amps Conductor Type Size ❑Multi-Family(Main)Service P0-100 amps ❑101-150amps [I151-200amps E1_____—amps #of Unit Meters_ emporary Pole q_100amps SERVICE UPGRADE []____:amps ❑ CT Service amps NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.) ❑100 amps ❑150amps 0200amps ❑ amps ❑CT 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 61-100 mps Heat Circuits: # circuits(a3 kw Number of Lighting Outlets, Including Fixtures: OTHER ELECTRICAL PROJECTS []SwimmingPool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motorshp FIRE ALARM SYSTEM (Requires 3 sets of plans) Qty volts/amps VALUE OF WORK$ REPAHLSIMISCELLANEOUS ❑Replace Bumt/Damaged Meter Can ❑Safety Inspection []Panel Change ❑OHto 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 nor The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction. /s �� � Property Owners Name Cal%/J'kA k n AILS �0AVtAkt*i� Phone Number Electrical Company 11-I/ JR%sfyicexf C. Office Phone 2YL' W /J Fax Co.Address: "o L' I�tK City » R— State JEL—Zip -f2-J" License Holder(Print): State Certification/Registration# Not a}EAG '¢areae or yN' ay CoWISSIONOFK2 l . ,; EXPIRES',October B,2019 afore mes day 2 s$ ✓ BaMeaiAry ro'2rv.to,6,2019aa Signature of Notary Public ATLANTIC BEACH PERMIT RECEIPT u � October 3, 2016 PERMIT DESCRIPTION: ELECTRIC-TEMP POLE C41- PERMIT NUMBER: 16-ELK-2231 3 iS3 ADDRESS:576 COASTAL OAK LN W "o OWNER: State Elec DBPR Surcharge $2.00 State Elec DCA Surcharge $2.00 Temporary Electrical Service $35.00 Trade Permit Base Fee $55.00 Totals: $94.00 PAID OCT 0 3 2016 CITY OF ATLANTIC BEACH