340 8th St temp pole permit - new contractor CITY OF ATLANTIC BEACH
y 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-2883
Job Type: ELECTRIC ONLY
Description: Temporary Pole 60 AMPS 240 VOLTS 1 PHASE
Estimated Value: $500.00
Issue Date: 12/28/2016
Expiration Date: 6/26/2017
PROPERTY ADDRESS:
Address: 340 STH ST
RE Number: 169928-0000
PROPERTY OWNER:
Name: Sifakis, Alex
Address:
GENERAL CONTRACTOR INFORMATION:
Name: ALLSTATE ELECTRICAL CTR INC.
,E00000113
Address: P O BOX 550617 CA JAMES L. WILLIAMS
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
/3O-T7 VY
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233 6--ae6_ZW3
/,,, R�Ph (904))247-5826 Fax(904)247-5845
JOBADDRESS: IVO V"' p r�I—• PERMIT# /(x-2774
JEA INFORMATION REQUIRED ON ALL PERMITS �(yLAMPS _VOLTS / PHASE
VALUE OF WORKS 'Sob
NEW SERVICE ❑ Overhead ❑ Underground ❑J Underground up Pole
❑Residential(Maio)Service
00-100 amps 0101-150amps 0151-200amps ❑ amps h!of Meters
❑Commercial(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps OCT Service_amps
Conductor Type Sue
[]Multi-Family(Maio)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
vilemporary,Pole `}-_(p
_amps
SERVICE UPGRADE ❑ amps ❑ CT Service maps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps I 0200amps ❑ amps ❑CT Service_amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Oudets/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 ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motors_hp
FIRE ALARM SYSTEM (Requires 3 sets of plans&Fire Alarm Checklist) VALUE OF WORKS
Qty_volts/amps
REPAIRS/MISCELLANEOUS
❑Replace BurnUDamaged Meter Can ❑Safety Inspection ❑Panel Change OOH to UG
Bother: n ��
- t
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 re be one and correct. All provisions of laws and ordinances governing this work will be complied with whether
specified or not 'me permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of
conswclim.
PropertyOwners Name p1 i S• k Phone Number 9d!s5/:�*VV
Electrical Company flyt 1 1 �i L rna14? Tr- OfficePhone4re,+Ila,»ee Fax k4W-s"''W
Co.Adtkess: 7441-7 city:3- . ll- Stated zip A=w
License Holder(Print): (//!/JYCa: < ��iAitl+ State Certification/Registration#
Notarized Si nature rr Li er �rla// ' '' ,, --
y"•, naCDYfl.amPo6 �'�.�.� 20�t
'�^+', arcoaMlssloaaRr+9rasa om and subscribed before me thi day of erg
EXPIRES.W17.2019
AFh
mmaereN re�,.,r�a=udr.a,a mature of Notary Publi —