1728 Maritime Oak Dr temp elec permit 'SI
r CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
61 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: 17-ELEC-2969
Job Type: ELECTRIC ONLY
Description: ELECTRICAL-TEMP POLE
Estimated Value:
Issue Date: 1/10/2017
Expiration Date: 7/9/2017
PROPERTY ADDRESS:
Address: 1728 MARITIME OAK 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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233 -7-
_zG11wp,
/Ph(904x)f 247-58266 Fax(904 247-5845
JOB ADDRESS: f MWy'TF fi•l ( 1A Y PERMITT# /( -' K-ZZ.9$
JEA INFORMATION REQUIRED ON ALL PERMITS Zw AMPS ZYU VOLTS a� PHASE
VALUEOFWORKS
NEW SERVICE ❑ Overhead ❑ Underground ❑I Underground up Pole
OResidential(Main)Service
00-100amps D 101-150amps ❑151-200amps ❑ amps #of Meters_
OCommereial(Main)Service
❑0-100 amps 0101-150amps 11151-200amps F amps ❑CTService_amps
Conductor Type Size
gMulti-Family(Main)Service
L;0-100amps 101-150amps D151-200amps 17111ups of Unit Meters_
[iTemporary Pole '� 30 loops
SERVICE UPGRADE ❑ amps QCT Service_amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
r 100 amps ❑150amps C200amps C amps OCTService_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(?FkW
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ESign ❑Smoke Detectors_Qty -Transformers KVA CMotors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty_volts/amps VALUE OF WORKS
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can 1, Safety Inspection ']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 perm¢does not give authority m violate the provisions of my other state or local law regulation construction or the performance of
construction. I
Property Owners Name�V Pl Sf CLQ (1�n6m ez Phone Number
EElectric.]Company AA'.�UNxJtJ GG cant pry Officephone 3Z'S`/-73 Fax 7f•I(r��gr�,'''�
Co.Address: �� 1 'x°"n�N �t ,Orf'. City State /Fai- Zip2 , 7
License Holder(Print): State Certification�/Registmtion# L2 ck-() l-71Y
Notarized Signature ofLtcense Holder v' f.Ci
r« cmtls:A. ma�s Swom and subsc
nbed before me this IUB dayof Tc.,,,,,i 201_7
Notary Peptic-stale of hoiiAa
commission x FF 943955 Signature of Notary Public
' yd' MY Comm.Expires Bee 15.2019
Bottled through National Witty Assn.