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Inspection Report
City of Tybee Island
403 Butler Avenue
P.O. Box 2 749
Tybee Island! GA 31328
Phone: 785 -4573 extensions 104, 107, or 114
Fax: 786 -9539
Permit No. ( * & - 0 L 3 3 Date Requested:
Owner's Name: �� �Q Date e
Needed:
Gen. Contractor: Subcontractor: � � SSe �,f G
Contact Number: n i 5,! �Q- ':R L} L4- 1,30-7
Location: `4 M , I l y- Ave-).
Date of Inspection: glI& Type of Inspection: I Do c+ V--�V
Comments: r P Ste'
a�
Inc.nf-ftnr! Time of Inspection:
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* * * * * * * * * * * * * ** -Comm. ?NAL- * * * * * * * * * * * * * * * * * ** DATE AUG -10 -209 K * ** TIME 10:06 * * * * * * **
MODE = MEMORY TRANSMISSION START= RUG -10 10:05 END = RUG -10 10:06
FILE N0. =534
STN COMM. ONE- TOUCH/ STATION NAME /EMAIL ADDRESS /TELEPHONE N0. PAGES DURATION
NO. ABBR NO.
001 OK s 4438877 001/001 00 :00:20
-CITY OF TYBEE ISL. -
****** * * * * * * * * * * * * * * * * * * * * * * * * * * * * *1* -CITY OF TYBEE - * * * ** - 912 786 9539- * * * * * * * **
RELEASES FOR ELECTRIC SERVICE FROM TYBEE ISLAND
FOR SAVANNAH ELECTRIC. FAX TO: Lynn Brennan 9*37 Phone 912443-5063
t7b -n-t33 4R h
Location Address: L4 /1� \ . � � per' Ay (v , Lot # Release Date: Sep
/ )v�e4er- elewej
Type of Release: Temporary ✓ Permanent Subd Name:
Electrician: ��-, a eI It Electrician Phone Number: q,4 1 4 - I
Owner /Builder: M o as —PQ 8, a r%– Phone Number: -7g% -_S0,C
Q
I Location Address:
Lot # Release Date:
Type of Release: Temporary _ Permanent Subd Name;
Electrician: Electrician Phone Number;
Owner/Builder: Phone Number:
Location Address:
Type of Release:
Electrician:
Owner/Builder:
Lot # Release Date:
Temporary Permanent Subd Name:
Electrician Phone Number:
Phone Number:
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' I R E L E A S E S F O R E L E C T R I C S E R V I C E F R O M T Y B E E I S L A N D
F O R S A V A N N A H E L E C T R I C . F A X T O : L y n n B r e n n a n 9 3 7 P h o n e 9 1 2 - 4 4 3 - 5 0 6 3
( 4 1 1 3 - R S " 7 / 7
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L o c a t i o n A d d r e s s : L 4 % y ` , Q } ' A V V . L o t # R e l e a s e D a t e :
/ A e . ��} e �� " ? e . l e a s v
T y p e o f R e l e a s e : T e m p o r a r y P e r m a n e n t S u b d N a m e :
E l e c t r i c i a n : E l e c t r i c i a n P h o n e N u m b e r : q i - 4 L 1 - 3 0
O w n e r / B u i l d e r : A 0 a a P h o n e N u m b e r :
L o c a t i o n A d d r e s s :
T y p e o f R e l e a s e : T e m p o r a r y
E l e c t r i c i a n :
O w n e r / B u i l d e r :
L o c a t i o n A d d r e s s :
L o t # R e l e a s e D a t e :
P e r m a n e n t S u b d N a m e :
E l e c t r i c i a n P h o n e N u m b e r :
T y p e o f R e l e a s e : T e m p o r a r y P e r m a n e n t
E l e c t r i c i a n :
O w n e r / B u i l d e r :
P h o n e N u m b e r :
L o t # R e l e a s e D a t e :
S u b d N a m e :
E l e c t r i c i a n P h o n e N u m b e r :
P h o n e N u m b e r :
DATE ISSUED: 08 -9 -2006
WORK DESCRIPTION:
WORK LOCATION:
OWNER NAME
ADDRESS
CITY, ST, ZIP
CONTRACTOR NAME
ADDRESS
CITY STATE ZIP
FLOOD ZONE
BUILDING VALUATION
SQUARE FOOTAGE
OCCUPANCY TYPE
TOTAL FEE'S CHARGED
PROPERTY IDENTIFICATION #
PROJECT VALUATION
CITY OF TYBEE ISLAND
BUILDING PERMIT
ELECTRICAL PERMIT
4 MILLER AVE
MONA PAGAN
PO BOX 913
TYBEE ISLAND GA 313280913
JOHNNY RUSSELL
1714 WILMINGTON ISL RD
SAVANNAH GA 31410
P
$ 25.00
$ 400.00
PERMIT #: 060433
TOTAL BALANCE DUE: $ 25.00
It is understood that if this permit is granted the builder will at all times comply with the zoning, subdivision, flood control, building, fire,
soil and sedimentation, wetlands, marshlands protection and shore protection ordinances and codes whether local, state or federal, including
all environmental laws and regulations when applicable, subsequent owners should be informed that any alterations to the property must be
approved by the issuance of another building permit. Permit holder agrees to hold the City of Tybee Island harmless on any construction
covered by this permit.
This permit must be posted in a conspicuous location in the front of building and protected from the weather. If this permit is not posted
work will be stopped. The building contractor will replace curb paving and gutter broken during construction. This permit will be voided
unless work has begun within six months of the date of issuance.
Signature of Building Inspector or Authorized Agent: ( Li,
P. O. Box 2749 - 403 Buffer Avenue, Tybee Island, Georgia 31328
(912) 786 -4573 - FAX (912) 786 -5737
www.cityoftybee.org
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CITY OF TYBEE ISLAND
k ELECTRICAL PERMIT & TEMPORARY SERVICE AFFIDAVIT
Property address:
Date:
Owner's name:
Contractor's name:
Owner's address:
Contractor's address i.i } y W5- I r� ` ) /�O
Owner's telephone:
Contractor's telephone: b y y —j 3
Type of Construction: New Renovation
Date Inspection Needed: L,_> . �L
PLEASE CHECK ALL THAT APPLY:
Application for electrical permit
I Application for temporary service:
APPLICATION FOR PERMIT
A/C Window
Intercom System
Range Split
Pool Ground
Air Compressor
ILoudspeaker System
Ranos
TelePhorms
Attic Ventilation Fan
Meter Box
Outlets -110:
Serviow.
Bell Transrrtttar
Microwave Oven
15 or fewer
60 amps or less
Border /Outline Lighting
Motor (s):
16-25
61 -100 amps
Building Saw
0-1 hp
26 to40
101 - 200 amps
Coiling Fan
1-3 hp,
41 to 70
201- 400 amps
Central Vacuum
3-8 hp
71 to 100
401 -1500 amps
Dishwasher
8-15 hp,
101 or more
T Service
Disposal
15-25 hp
Receiver Disc
Thermostat
Dryer
25-50 hp
Rectifiers
TV Jacks
Exhaust Fan
50 -100 hp
Sign Circuit
Water Heater
Exit Lights
over 100 hp
Smoke Detector
Washing Machine
Food Processor
Parking Lot Lights
Spas & Tubs
Well Pump
Garage Door Opener
ARange
Pod Lights
Special outlet
Welders
Heater
Post Light
Strip Heat
24ay
Ice Maker
Hood
I
Pmkmrmng Pod
APPLICATION FOR TEMPORARY SERVICE REQUEST
In requesting temporary electrical service, the undersigned understand and agree:
1. Connection of temporary electrical service provides does not remove the requirement to comply with all State of Georgia
minimum construction codes.
2. Temporary electrical power is intended for completion of the construction process and testing equipment installed within
the structure.
3. Issuing approval for temporary power connection does not constitute approval to occupy the structure. A Certificate
of Occupancy must be issued by the City of Tybee Island prior to any oocupancy.
4. The owner and contractor are hereby held responsible for any violations of this policy. A violation of this policy may result
in disconnection of the electrical service until all violations and deficiencies are corrected.
Owner's signature: Date:
Contractor's signature: Date: �2' ` �-3' - 0 (-P
Approval:
Code Enforcement Officer: Date:
Community Development Director: Date:
Fee: Initials:
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