745 Amberjack - Temp Pole CITY OF ATLANTIC BEACH
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800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
ELECTRICAL TEMP POLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: TEMP17-0035
Description: 60 amps, 240 volts, 1 phase
Estimated Value: 100
Issue Date: 12/5/2017
Expiration Date: 6/3/2018
PROPERTY ADDRESS:
Address: 745 AMBERJACK LN
RE Number: 171197 0000
PROPERTY OWNER:
Name: CLAY REALTY INVESTORS INC
Address: 745 AMBERJACK LN
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: SCHUMAN ELECTRIC INC.
Address: PO BOX 48171 QA JOHN JASPER SCHUMAN
JACKSONVILLE, FL 32247
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB
SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
De c. 5. 2017 11 : 11 AM No, 5093 P. 1
]ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
�] �f Ph(904) 247-5826 Fax(904)2475845
JOTS ADDRESS: / 1 5 A_ m bLx )CCC IL CA n-1— PERMIT#15611-7—C S
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS �VOLTS .1- PRASE
VAL UE OF WORK$ _/ab . 00
NEW SERVICE [ 1 Overhead ❑ Underground Underground up Pole
❑Residential (Main)Service
❑0-100 amps ❑101-150amps ❑151-200amps []_amps # of Meters
❑Commercial(Main) Service
DO-100 amps 0101-1.50amps L151-200amps amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
❑0-100 amps ❑j o150amps ❑151-200amps ❑ amps #of Unit Meters
>01emporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
LJ 100 amps L 150amps 7200amps amps 17CT Service amps
ADDITION'S,REMODELS,REPAIRS,BUILD-OUTS,,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: —0-30amps 31-100amps 101-200amps
Appliances: 0-30arnps 31-100arnps 101-200amps
A/C Circuits. 0-60arnps 61-100amps
Heat Circuits: # circuits c@ kw
Number of fighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
LJ Swimming Pool 0 Sign ❑Smoke Detectors_Qty C1 Transformers ICVA, (l Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VAL UE OF WORK$
REPAIRS/MISCELLANEOUS
F1 Replace Burnt/Damaged Meter Can F1 Safety Inspection ❑Panel Change (JOEY 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►he provisions of any other state or local law regulation construction or the performance of
construction. p /
Property Owners Name �Ltu l aI 1 �1'1�,p s Phone Number 6 q r 7
Electrical Company 1'rY'1CL 7 ),e v )c-, Office Phone -7S?-1-1p1,1Q Fax_ .Giro LfIO
Co.Address: C) `7 I City_ State R, Zip 3 2.2
License holder (Print); State Certification/Registration# i2�
No der
_ y MOLL* WALDEN
•: MY COMMISSION#Qawaaes worn a subs ed before me thi _day of �IYI ��t' 20�
EXPIRES November 25,solo ignatur otary Public
y
r�
Cash Register Receipt Receipt Number
City of Atlantic Beach • •
DESCRIPTION ACCOUNT CITY PAID
PermitTRAK $94.00
TEMP17-0035 Address: 745 AMBERJACK LN APN: 171197 0000 $94.00
ELECTRICAL $90.00
ELEC TEMP SERVICE 455-0000-322-1000 0 $35.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.00
STATE DCA SURCHARGE 45500002080700 0 $2.00
TOTAL FEES • $94.00
Date Paid:Tuesday, December 05, 2017
Paid By: SCHUMAN ELECTRIC INC.
Cashier: LE
Pay Method: CREDIT CARD 035189
/ ,
Printed:Tuesday, December 05, 2017 2:30 PM 1 of 1 1
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