1781 Atlantic Beach Dr temp pole permit CITY OF ATLANTIC BEACH
j 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-3522
Job Type: ELECTRIC ONLY
Description: TEMP POLE - 30 AMPS
Estimated Value:
Issue Date: 3/17/2017
Expiration Date: 9/13/2017
PROPERTY ADDRESS:
Address: 1781 ATLANTIC BEACH DR
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: MCDONALD ELECTRIC
,E00001794
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 THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233 I y L 3 S z Z
Ph(904)247-5826 Fax(904)247-5845 [
JOB ADDRESS: /7 8/ /7_1{'/c.i�c 4—L 1 PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK S
NEW SERVICE ❑ Overhead ❑ Underground DUnderground up Pole
DResidential(Main)Service
00-100 amps E 101-150amps ❑151-200amps I amps #of Meters
GCommercial(Main)Service
10-100 amps ❑101-150amps x 151-200amps - amps C'CT Service_amps
Condncmr Type Size
❑Multi-Family(Main)Service
r_0-100amps 1,101-150amps D151-200amps - amps #of Unit Meters
_-Temporary Pole i3-damps
SERVICE UPGRADE !.:! amps Cl'Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
=:100 amps E 150amps D200amps amps DCT Service amps
ADDITIONS,REMODELS,REPAHLS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
OutlerstSwitches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: ___9-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
-Swimming Pool GSign --]Smoke Detectors_Qty -:Transformers KVA -Motorshp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK S
REPAHIS/MISCELLANEOUS
Replace Burm/Damaged Meter Can '.-Safety Inspection -1Panel Change SOH to UG
_:Other.
Perish becomes wid ifwark docs not rommcree 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 we 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 of violate the provisions of any other slate or local law regulation construction or the performance of
constnmtlon. -''//--
Property Owners Namc I Phone Number
Electrical Company i'1'i`/�a r>Ja� E4 L r�ri Office Phone !�5 '" 'P- 3 Fax -7,616- "I Y
Co.Address: City J-117C State r Zip 3z:L3''�
License Holder(Print): to-IVis _'x_14 SStaie Certification/Registration# �L01/0 /n9 t/
Notarized Signature of License Holder GF -
"""'•
CHRISM THOMAS Swotn and subscribed before me this 17 LA day of 12 cw c, 201-1
eF t''•; wary PaallC-Stale of Florida Signature of No Public
Commission n EE 943955
MY Comm.Expires Dec 15.2o19
Bonded IMough National Notary Assn.