1535 Selva Marina Dr temp pole permit CITY OF ATLANTIC BEACH
sI 800 SEMINOLE ROAD
o ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
30B INFORMATION:
Job ID: 17-ELEC-3285
Job Type: ELECTRIC ONLY
Description: temporary pole - 60 amps/240 volts/single phase
Estimated Value:
d Issue Date: 2/17/2017
Expiration Date: 8/16/2017
PROPERTY ADDRESS:
Address: 1535 SELVA MARINA DR
RE Number: 171948-0000
PROPERTY OWNER:
Name: 1535 Salva Marina Drive LLC
Address: 501 Riverside AVE
GENERAL CONTRACTOR INFORMATION:
Name: LORE ELECTRICAL CONTRACTORS
Michael Lee Lore, EC13006692
Address: 210 N ROSCOE BLVD QA MICHAEL LEE LORE
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
`^ Ph(904) 247-58266 Fax(904)247-5845
JOB ADDRESS: 153 S vt Iy, �Y1,CHLj,V,g A ' PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 60 AMPS 2 t%oVOLTS PHASE
VALUE OF WORKS 0 0
NEW SERVICE ❑ Overhead ❑ Underground ❑1 Underground up Pole
❑Residential(Main)Service
00-100 amps ❑101-150amps ❑151-200amps Damps #of Meters
❑Commercial(Main) Service
❑0-100 amps 101-150amps 11151-200amps ❑ amps 0 C Service_mpg
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps /E 101-150amps ❑151-200amps ❑ amps #of Unit Meters
glfemporary Pole Vdamps
SERVICE UPGRADE : I amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100amps 0150amps 0200amps ❑ amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUD -OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motorshp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Bumt/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 for six months. I hereby certify that 1 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.
Property Owners Name Phone Number
Electrical Company �n� G�EG7R'cfcJ11 C bb,�TMC Office
Phone 273 //q3 Fax 373^F"iri /ro/J
Co.Address: 2( 6 • If4.5-coE is(V4 City)f' V State Y Zip
/7
License Halder (Print): / '/1 l c rte State Certification/Registration# 301?o 2 L
Notari pof i-,-o..-LLplder 7,//— >�
♦"c""'•, JENNIFER JOHNSTON t ^
CAMNISSIONUGG0119s< efore me this day ofCb(U& 20 I T
2.: ': EXMRES:OIssAxn 21.2020
,Fr; eorm.aTro,NONaras "m Signature of Notary Public SAB