356 10th St temp elec permit Amk CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
qw INSPECTION PHONE LINE 247�5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-ELEC-3185
Job Type: ELECTRIC ONLY
Description: TEMP POLE - 50 AMPS 240 VOLTS 1 PHASE
Estimated Value:
Issue Date: 2/6/2017
Expiration Date: 8/5/2017
PROPERTY ADDRESS:
Address: 356 10TH ST
RE Number: 170043-0000
PROPERTY OWNER:
Name: PEROLOF, EZELILIS
Address: 356 10TH ST
��E-NERALCONTRA�CTOR INFORMATION:
Name: KNIGHT ELECTRIC LLC
, ER13012523
Address: 908SIlTHAVE QA MARK STEVEN KNIGHT
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
Tow Payments: $94.00
PERIWIT IS APPROVED ONLY IN ACCORDANCE NVITH 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 1-7-EJ-elf--3krl
Ph(904)247.5826 Fax(904)247-5845 PERMIT#
JOB ADDRESS: '7570 /op-
JEA INFORMATION REQUIRED ON ALL PERMITS —21—AMPS —Zq—o VOLTS PHASE
VALUE OF WORK S
NEW SERVICE D Overhead Underground D Underground up Pole
'Residential(Main)Service #of Mchers
LJO-100 amps �101-1503hhtpfi i 115 1-200sraps I _amp&
(Acommercial(Main)Service
L10-100arrips 1 .101-150amps i5i-200amps I I—amps OCT Service_amps
Conductor Type_ Sin
i-Multi4amily(Main)Service #of Unit Mottes
�10-100 mpg L.WI-15ORMPS i 151-200waps U----=Ps
lffeasporary Pole -1—So amps
SERVICE UPGRADE lj—mps I CT Service_mpg
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC-)
F1100araps L1150amps t 1200hurps U____—mps 1'CT Service_mpg
ADDITIONS,REMODELS,REPAIRS,RUILD-OUTS,ACCESSORY STRUCTURES,ETC-
Outlests(Switches: —0-30amps 31-100%mps 101-2004mps
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
L7SwimmingPool I I Sign OSmokeDertoctM_Qty FTransformers KVA --Motors_bp
FIRE ALARM SYSTEM (Requires 3 sets of Plans)
Qly—volta/mpg— VALUE OF WORK S—
REPAIRSIMISCELLANEOUS
,lReplace Buint/Darmaged Meter Can i Safety Inspection (Tariel Change COR to UG
20ther; ona�
ha
Pennit khtmxoiss void if work doo-at commeme within a six month period or work is stupended or abandoned for six NTftths I hereby=lfy t t i have
read this application and kmw the gane to be no md correct. All provisions of laws ad ordinmes,governing this Work will to�piied with whether
specified m not The pernot does not give authority to violaw the provisions of My other sune or loco low mlialdon construction or the pefforgasura of
conshuction.
Property Owners Name Arlo Phone Nurnber
Electrical Company <A,, r atv—g( Officephone 24.7JrA Fax -AUAV
Co.Address: q0t I/M Ae 5- city—:kp state—zip
License Holder(Pirint)- State Certifioation/Regilittationlik 04y)(2-M
Notarized Signature or License Holder.
Jw% 140TARY K0jC Sworn and subscribe I I�fb
�STATF OF R�MDA
twcawomowm Signature of Notar�=Iir!�
iim2rAIV
CITy OF ATLANTIC BEACH
Boo SEMINOLE ROAD
ATLARTIC BEACH. FL 37z33
PHONE �900 247-5826
C,&i,r Id' atlbcld\atibbia
Receipt Daje, 7/6M17 2:56:00 RM
Receipt Wilber: OS-72367
3,b ID- 17-ELEC-3185 - TEMP POLE - 50 AMPS
240 VKTS I PHASE EDBPR - State El K DBPR S
urcharge U-00
job JD- 17-ELEC-3185 - TM POLE - 50 AMPS
240 VRTS I PHASE EBB - State Elec DCA Sur
Charge $2.00
J,b ID' 17-ELEC-3185 - TErf P%E - 50 AMPS
240 yo[TS I PHASE EL6 - Teopwary Services
$35.00
klb ID' 17-ELEC-3185 - TEMP POLE - 50 NfS
240 �KTS I PHASE TP - Trade P"nt Base Fe
e $55.00
Aminunt Due' $9q-00
Tender lnf�rmatlw: Cash $94-00
Tender Type: CC
lend,, Amount: $94.00
Charge Due: 10-00
CITY OF ATLANTIC BEACH
800 SEMINOLE RD
ATLANTIC BBC,R-32233
O�06,'2017 149:43
CREDIT CARD
VISA SALE
Card# WW=7903
SEQ 4� 6
Bab#: 295
INVOICE 6
Approval Code: 035448
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Tax Arrad: $000
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Card Code: M
SALE AMOUNT
CUSTOMER COPY