1829 Atlantic Beach Dr temp pole permit .i y-'Lyr
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
D;',-;'09f'
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
IOB INFORMATION:
Job ID: 16-ELEC-2427
Job Type: ELECTRIC ONLY
Description: temporary electrical service - 30 amps/240 volts/single
phase
Estimated Value: $100.00
Issue Date: 10/28/2016
Expiration Date: 4/26/2017
PROPERTY ADDRESS:
Address: 1829 ATLANTIC BEACH DR
RE Number. None
GENERAL CONTRACTOR INFORMATION:
Name: MCDONALD ELECTRIC
EC0001794
Address: 6915 WEST BEAVER ST QA LARRY BRIAN CARTER
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 DI ACCORDANCE WITH ALL CM OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
Ph(9�0}4�)247-5826 Fax(904)247-5845
JOB ADDRESS: (3Z✓'J A '1-4tli PjEac h Ji PERMIT# 16-Sr-r-- /`77(0
JEA INFORMATION REQUIRED ON ALL PERMITS 30 AMPS VOLTS ) PHASE
,�VALUEOFWORKS 100-W
NEW SERVICE ED Overhead lJ Underground ❑f Underground up Pole
❑Residential(Main)Service
❑0-100 amps 0101-150amps ❑151-200amps ❑ amps of Meters
❑Commercial(Maio)Service
❑0-100 amps !:!101-150amps 0151-200amps ❑ amps ❑CTService_amps
Conductor Type Size
❑Multi-Family(Main)Service
110-100amps 11101-150amps ❑151-200amps ❑ amps #of Unit Meters
❑TemporaryPoleXl__4�amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100amps ❑150amps 0200amps ❑ amps DCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
OutleWSwitches: 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 ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motors_hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORKS
REPAIRS/MISCELLANEOUS
L Replace Burnt/Damaged Meter Can U Safety Inspection ❑Panel Change ❑OH to UG
❑Other:
Permit becomes void if work does not commence within a sin month period or work is suspended or abandoned for sin months. I hereby certify that I have
read this application and know the some 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 %OLL A9✓O N/✓1 Phone Number
Electrical Company /'ntI)ONG-lU (56,cnz, Office Phone 35�-4ti'73 Fax 7Bb-l9dS/
Co.Address: 3zf/ [.✓- e-^✓-'� -' City J✓q Stater' Zip z
License Holder(Print): lcv✓ A9 n .�State Certification/Registration# 6Z&O t 'A4y
Nq t;d Signature ojLrcense7Lolder
Notal Punic Stale al Fwnda Sworn and subscribed before me this day of Oc-66, 20�
_ - Commission r FF 947955
My Comm.Eapims Dec 15,7019 Signature of Notary Public [�
'�P,;,:k '` BaneeUlhrouAh National NolaY Pssn.