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�