570 COASTAL OAK DR - TEMP POLE CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
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-3493
Job Type: ELECTRIC ONLY
Description: ELECTRIC - TEMP POLE
Estimated Value:
Issue Date: 3/15/2017
Expiration Date: 9/11/2017
PROPERTY ADDRESS:
Address: 570 COASTAL OAK LN
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND TILE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC l EACH
800 Seminole Rd, Atlantic Beach,FL 32233
Ph (904)247-5826 Fax (904)247-5845 1 / -ELLC -34 c-13
JOB ADDRESS: 570 G0,-S re/1- OAC Lr/ PERMIT#
JEA LNFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK$ /tO• °I)
NEW SERVICE ❑ Overhead ❑ Underground J Underground up Pole
2Residential(Main)Service
;30-100 amps _101-150amps 151-200amps amps #of Meters
• Commercial(Main)Service
-0-100 amps !_101-150amps _151-200amps 7 amps _)CT Service amps
Conductor Type Size
:Multii-Family(Main)Service
.. 0-100 amps 101-150amps "1;151-200amps - amps #of Unit Meters
Temporary Pole 30 amps
SERVICE UPGRADE amps _ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
7100 amps 150amps . 200amps 1 amps =CT Service 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 @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
' _Swimming Pool 2 Sign :Smoke Detectors Qty -Transformers KVA EMotors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
•-'Replace Burnt/Damaged Meter Can !. Safety Inspection ^'.Panel Change TOIL 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 noL 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 low £✓0f #I, 5 Phone Number
Electrical Company M ei)uty „J"f g(, ,t..t Office Phone Fax
k Co.Address: 3?-11 W• al2ct.t/v- City J State R. Zip 32 Z
License Holder(Print):' ( 6.4-' ' State Certification/Registration# EZ v x t'-)5 ti
i 'L-y
Notarized Signature of License Holder
., . 20/?
.�`� ill o CHRIS M. THOMAS worn• and subscribed before me this /5 — day of /SIG rzA
° Notary Public-State of Florida
t Commission #FF 943955 .ignature of Notary Public . ^
',,;F.� Pec My Comm.Expires Dec 15.2019
Bonded through National Notary Assn.