589 Coastal Oak Ln temp pole permit .S I
r CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
` ze 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-3216
Job Type: ELECTRIC ONLY
Description: temporary pole - 200 amps/240 volts/single phase
Estimated Value: $100.00
Issue Date: 2/9/2017
Expiration Date: 8/8/2017
PROPERTY ADDRESS:
Address: 589 COASTAL OAK LN
RE Number: None
PROPERTY OWNER:
Name: RIVERSIDE HOMES OF N FL
Address: 414 OLD HARD RD STE 502 MATTHEW ROBERTS
GENERAL CONTRACTOR INFORMATION:
Name: MCDONALD ELECTRIC
,EC0001794
Address: 6915 WEST BEAVER ST CA 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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITM ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845 q-E(•E L- 3 e31 O
JOB ADDRESS: (o*s*/ o A,�5 LN PERMIT# 17- 5Y2 -A)Yr
JEA INFORMATION REQUIRED ON ALL PERMITS eCO AMPS 'Z�4U VOLTS PHASE
VALUEOFWORK$ 1t27. 0b
NEW SERVICE ❑ Overhead ❑ Underground ❑1 Underground up Pole
OResidential(Main)Service
00-100 amps 0101-150amps 0151-200amps G amps 4 o Meters_
OCommereial(Main)Service
00-100 amps 1:I01-150amps 0151-200amps — amps ❑CTServim_amps
Conductor Type Size
(Multi-Family(Main)Service
00-100amps '1101-150amps D151-200ampsamps #of Unit Meters
❑Temporary Pole CP3�_ amps
SERVICE UPGRADE J--amps ❑ CT Service_amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
C 100 amps O 150amps C-200amps n amps OCT Service amps
ADDITIONS,REMODELS,REPAILS,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 Q kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
-^Swimming Pool -- Sign -]Smoke Detectors_Qty OTtansformers KVA OMomrs_hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPADRS/NUSCELLANEOUS
:'Replace Burt/Damaged Meter Can ❑Safety Inspection ❑Panel Change OOH to UG
❑Other:
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned Por six months. I hereby certify that I have
read this application and(mow,the same to be trne 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 scale or local law regulation construction or the performance of
construction. -
Property Owners Name �t / l06".r Phone Number
Electrical Company /�rlrjo t'..l t/ & 'e"t Office Phone Fax
Co.Address: 3Zr l w• /lj(a w City , )✓+f Stati 32215/
License Holder(Print): Y r State Certification/Registmtion# 4-'-0(V/_7�7 Y
N ler
wy ¢..•
y` r: Notary Public State of Florida om and subscribed before me this 8'= day of f b,-, 2017
Commission M FF 943955
H®A` My Comm.Expires aec 15,2019
'%`• �t°"O Bonded mmugh National Nor,Assn gnatnte of Notary Public /•