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325 Country Club Ln 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 JOBINFORMATION: Job ID: 16-ELEC-2381 Job Type: ELECTRIC ONLY Description: temporary pole -40 amps/240 volts/single phase Estimated Value: $200.00 Issue Date: 10/24/2016 Expiration Date: 4/22/2017 PROPERTY ADDRESS: Address: 325 COUNTRY CLUB LN RE Number: 171962-0000 PROPERTYOWNER: Name: GROVER JR, WILLIAM HOWE Address: 325 COUNTRY CLUB LN GENERAL CONTRACTOR INFORMATION: Name: MUNSON & BRYAN ELECTRICAL CO. , EC0001795 Address: 3434 ST AUGUSTINE RD QAJOHNMICHAEL SCIOLINO 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: $94 00 ;I IZNII I IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLAYHC BEACH ORDWANCES AM THE FLORIDA I ILDING CODES. ELECTRICAL PERMIT APPLICATION CITY OF ATLANTIC 13EACH 800 Seminole Rd,Atlantic Beach, FL 32233 Ph(904)247-5826 Fax:(904)247-5845 JOBADDRESS: 3Y--s e14,6 1�,.de PERMIT# JEA INFORMATION REQUIRED ON ALL PEPMWS 1/0 AMPS -Z-yd VOLTS . PHASE VALUE017WORKS -24)(9- 00 NEW SERVICE WO.,head Underground Underground up Pole DResidential(Main) Service 00-100 amps E1101-1150amps El 151-200amps 11 —amps 4 of Meters nCommercial(Main)Service 00-100 amps [1101-150amps El 151-200amps 0—amps EICT Service_amps Conductor Type_ Sim_ FlMulti-Family(Main)Semice EJO-100 amps U 101-150amps 0151-200amps El amps #of Unit Meters Fftemporary Pole amps SERVICE UPGRADE 0----jamps El CT Service_amps NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.) 0100amps D150amps [1200amps El amps 13CT Servicc_amps ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC. Outlets/Switches: —0-30amps 31-100amps —10 1-200amps Appliances: —0-30amfnr 3 1-1 00amps 101-200amps AIC Circuits: —0-60amps 61-100amps Heat Circuits: #circuits Number of Lighting Outlets, Including Fixtures: OTHER ELECTRICAL PROJECTS LlSwimmingPosol DSign USmokeDetcctors__Qty LiTransformers KVA OlvIlp FIRE ALARM SYSTEM (Requires 3 sets of plans) Qty—volts/amps— VALUE OF WORK$ REPAIRS/MISCELLANEOUS Fl Replace Burat/Damaged Meter Can El Safety Inspection UPanel Change 110H to UG I Other: permit becomes void ifwork docs not waruncrice within a six month period or work is suspended or abandoned for six months. I hereby certify that I he" read this application and know the sarne 0 be me and comet. All provisions of laws and ordfinances governing this work will be complied with whether specified or not. The pemut does not give authority to violate the provisions of my other state or local law regulation construction or the performance of construction. Property Owners Name cle Phone Number Electrical Company A601604 4md R&I-11 fJe�fA�' oflice Phone 1"00-,3 075�Fax Co.Address: 3q3'1 .51 d7ukMnie' tfd City -5-,*,g'�dlk Statej��qlp �F071�67 License Holder(Print): State Cerfification/Registrationit FC-00-i`79,�� Notarized Signature ofLicense Holder -1,0 201C Sworn an4lbscribed before me this o dav of 0 C-f0&e-r JOSEPH GUY CAUCHO — Conargelon#FF244825 Expires July 16,2019 Signature of Notary Public CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL K2 PHONE (904) 247-5955 Cashier Id: atlbcld\atlbbja Receipt Data: 10/24/2016 9:30:16 AM Receipt Rubber: OS-71556 Job ID' 16-ELEC-23BI - temporary pole - 40 ai wits/single phase EDBFR - State E 1,, DBPR Surcharge $2.00 Job ID- IG-ELEC-2381 - temporary pole - Q amps/2jo �Itd/single phase EDER - State El s, DCR Surcharge $2.00 job ID- IG-ELEC-2381 - temporary pole - 40 Nips/240 ,Its/single phase E-6 - TemporarY S,,r vices $35.00 Jcb ID- IG-ELEC-23Bl - teminaePY Pole - 40 ,p,/50 Iis/si'lle phase TP - Trade Per% it Base Fee $55. 0 Job ID: 16-ELEC-2302 - neu FlutPical sisr" c, - 300 amps/240 vults/ single phase EDBPR - state Fl K DBPR Surcharge $2.00 job ID: 16-ELEC-2387 - ne� el ectrical servi - 300 p,/240 wlt-/ single phase EDCfi State El , DCA Surcharge $2.00 Job ID' 16-ELEC-2392 - — electrical mrvi ce - 3k amps/2qO vDits/ sinve Phase ELI RL, Single Family Electrica 9O.DG Job ID- IG-ELEC-M - neu electrical Servi Ce - ko mp,/2W wlts/ single Phase TP Trade Permit Base Fee $55.00 Amount Due, $243.00 Tender Infwmatiun: Cash $243.00 Ten,der Type: DO Tender Amount: $243.00 Change Due; $0-00 CITY OF ATLANTIC BEACH L, BID SEVENOLE RD K ATLANTIC BEAC,R.32233 10/24/2016 09:29:45 CREDIT CARD mc SALE Card ZODOMD451 SEQ#: I W#: 231 INVOICE I Approval Code: 23955K Er"W)Dd: mnw mok 'E Onh N A T M T I C M LE I LC E FLBEACH R, "2,3 D 0' OMM" 9 4' 045 23 1 L955K Onh Tax knoW: Cad Cok SALE AMOUNT $N3.W —----- CSTOMER COPY]