275 SHERRY DR - TEMP POLE PERMIT s CITY OF ATLANTIC BEACH
'~ J 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
.H �f.
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-ELEC-3084
Job Type: ELECTRIC ONLY
Description: ELECTRIC - TEMP POLE
Estimated Value: $500.00
Issue Date: 1/26/2017
Expiration Date: 7/25/2017
PROPERTY ADDRESS:
Address: 275 SHERRY DR
RE Number: 169802-0000
PROPERTY OWNER:
Name: BCEL 5 LLC
Address: 7563 Philips HWY STE 109
GENERAL CONTRACTOR INFORMATION:
Name: ALLSTATE ELECTRICAL CTR INC.
, EC0000113
Address: P 0 BOX 550617 QA JAMES L. WILLIAMS
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
Ph(904)247-5826 Fax (904)247-5845
JOB ADDRESS: 275. 402,40,7 PERMIT#4.14,4
JEA INFORMATION REQUIRED ON ALL PERMITS CO AMP Vd VOLTS / PHASE
VALUE OF WORK$ O
NEW SERVICE Overhead Underground J Underground up Pole
❑Residential(Main)Service
00-100 amps D 101-150amps 0151-200amps 0 amps #of Meters
0 Commercial(Main)Service
00-100 amps 0 101-150amps 0151-200amps 0 amps OCT Service amps
Conductor Type Size
0Multi-Family(Main)Service
00-100 amps ❑101-150amps D 151-200amps 0 amps #of Unit Meters
Vremporary Pole 0 amps
SERVICE UPGRADE D amps 0 CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps 0150amps 0200amps 0 amps OCT 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 0 Sign 0 Smoke Detectors Qty ^Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans& Fire Alarm Checklist)
Qty volts/amps VALUE OF WORK S
REPAIRS/MISCELLANEOUS
OReplace Burnt/Damaged Meter Can 0 Safety Inspection OPanel 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 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 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 4gf! .E. _ -5- �C� Phone Number J.59/7/
Electrical Company Alai- ` ( ( Office Phone -2 -2.A6 Fax '-1 17/
Co.Address: 7y .47c l.S�--� ��1- City State Zips%.
License Holder(Pri t • _ ?, ' 4-‘,///41,0"<- State Certification/Registration# Eek"3
S .q Holder 9-4edogie
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• .nv;•_ (;DmmISSI0n #FF 230355
My Comm. Expires Jun 1,2019 I Sworn and subscribed befor this Z3&/ of 20)9
Bonded Cvgh National Notary Assn.` Signature of Notary Public