145 8th St temp elec permit `?f CITY OF ATLANTIC BEACH
r 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: 17-ELEC-3181
Job Type: ELECTRIC ONLY
Description: 60 amps/240 volts/single phase -temporary pole
Estimated Value: $100.00
Issue Date: 2/6/2017
Expiration Date: 8/52017
PROPERTY ADDRESS:
Address: 145 8TH ST
RE Number: 170323-0000
PROPERTY OWNER:
Name: Sellers, Jeffrey B
Address: 145 8Th ST
GENERAL CONTRACTOR INFORMATION:
Name: SCHUMAN ELECTRIC INC.
John Jasper Schuman III,EC13006884
Address: PO BOX 48171 QA JOHN JASPER SCHUMAN
Phone:904-737-4040
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
Ph(904)247-5826 Fax(904) 247-5845
JOB ADDRESS: I Uri Rib <v+' / PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS _&b_AMPS _Q VOLTS PHASE
VALUE OF WORKS lno .no
NEW SERVICE ❑ Overhead ❑ Underground ❑l Underground up Pole
❑Residential(Main)Service
CO-100 amps 11101-150amps 0151-200amps ❑ amps of Meters
❑Commercial(Main)Service
10-100 amps D101-150amps 0151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
PO-100 amps 11,)01-150amps 0151-200amps ❑ amps #of Unit Meters_
UTemporary Pole 0-00-11111113s
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100amps 0I50amps 0200amps ❑ amps ❑CTServiceamps
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 @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motorshp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORKS
REPAIRSAIISCELLANEOUS
❑Replace Bumt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG
❑Other: ..Jd Ieyl3e4[) -M( wle
Pemdt 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 permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of
construction. 1_ fl/�
Property Owners Name FC.-F�YP r'j 1P G Phone Number
Electrical Company &kUYY 4'n F�CD�-y(C t Ja I C OfficePhone X37-4146 ax_3% yl ay
Co.Address: - O C 17City StateFL Zip .` ,V q
License Holder(Print): State Certification/Registration# EC 13666M
Notarized Signature of License Holder t
HOV'V-WALDENwomand subscribed before me this day of F'cbrU" W6
MY COMMMSHM a 00014489
L. I7<PRW $aha *a 25.21120 ignature of Notary Public