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262 2nd st temp pole 2015 � 1S1 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: 15-ELEC-352 Job Type: ELECTRIC ONLY Description: temp pole Estimated Value: Issue Date: 2/17/2015 Expiration Date: 8/16/2015 PROPERTY ADDRESS: Address: 262 2ND ST RE Number: 172542-0000 PROPERTY OWNER: Name: SMITH III,CARL HOLT & JULIA L, Address: 4670 BADEN LN GENERAL CONTRACTOR INFORMATION: Name: UNITED ELECTRIC COMPANY OF Address: 5716 ST AUGUSTINE RD QA JOHN E GRIFFIN JR 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: $94.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ELECTRICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd, Atlantic Beach, FL 32233 Ph�904) 247-5826 Fax (904) 247-5845. JOB ADDRESS: a a S }'" T P PERMIT# 5-D��►o-a�) JEA INFORMATION REQUIRED ON ALL PERMITS O O AMPS Z O VOLTS PHASE ,VALUE OF WORK$ i So --01P NEW SERVICEOverhead F-1Underground ❑T Underground up Pole ❑Residential (Main) Service 00-100 amps ❑101-150amps ❑151-200amps O amps # of Meters ❑Commercial(Main) Service ❑0-100 amps ❑101-150amps 0151-200amps ❑ amps OCT Service amps Conductor Type Size ❑Multi-Family(Main) Service 0-100 amps - ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters Temporary Pole ❑ G 0 amps SERVICE UPGRADE ❑ amps ❑ CT Service amps NEW FEEDER(ADDITIONS,.ACCESSORY STRUCTURES,ETC.) ❑100 amps ❑150amIA 0200amps ❑ amps OCT Service amps ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC. Outlets/Switches: 0-3 Damps 31-l 00amps 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 ❑Motors hp FIRE ALARM SYSTEM (Requires 3 sets of plans& Fire Alarm Checklist) VALUE OF WORK$ Qty volts/amps REPAIRS/MISCELLANEOUS ❑Replace Burnt/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 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. &I Phone Number a 19 a L Property Owners Name 5�` � Lr�- n � o e —13 1- -0 Fax-13 I -53 Electrical Company fi Co.Address: S1 S o S ` �Z �` City State �L Zip 3�Z� 7 i t- 4c State Certification/Registration#6U300536-7License Holder(Print): Notarized Signature of License Holder i L%*-e '`���� Sworn and subscribed before me his� day of Fib 0 r- 20 RF-SDARCOIJIMISS ON tt FFIC7753Sl afore of Notary PublicEXP11US:April 23,2018sv.^.r.�:nrvt�a/mry�r�