526 Atlantic Beach Ct Temp18-0043 ,t ELECTRICAL TEMP POLE PERMIT PERMITNUMBER
CITY OF ATLANTIC BEACH TEMP18-0043
800 SEMINOLE ROAD ISSUED: 11/14/2018
%LD ATLANTIC BEACH. FL 32233 ERPIRES: 5/13/2019
• • . t ,ALL • • • •
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CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
NOTICE:In addition to the requirements of this permit,there may be additional restrictions applicable to this property
that may be found in the public records of this county,and there may be additional permits required from other
governmental entities such as water management districts,state agencies,or federal agencies.
- JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
526 ATLANTIC BEACH CT ELECTRICAL TEMP POLE $150.00
ZONING:TYPE OF REALESTATE G USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
ATLANTIC BEACH
169505 1410 COUNTRY CLUB UNIT 02
COMPANY: ADDRESS:
TRI COUNTY ELECTRICAL 11637 E COLUMBIA PRK DR JACKSONVILLE FL 32258
• ADDRESS:
RUMMANS ALBERT E JR 14 TURTLE RI DG E CT RIDGEFIELD CT 06877
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR 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.
LIST OF CONDITIONS
Roll off container company must be on City approved list. Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
ELEC TEMP SERVICE 455-0000-3221000 0 $35.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 555.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-20806M 0 $2'A
TOTAL:$94.00
Issued Date: 11/14/2018 1 of 2
--ALL ON
isElectrical Permit Application HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@ccab.us PERMITM
JOB ADDRESS:626 ATLANI1C'BEACH COUR7 �,.PROJECT VALUE W50.00-
JEA INFORMATION REQUIRED ON ALL PERMITS:_AMPS NM,VOLTS=PHASE
El NEW SERVICE: E3Overhead ClUnderground {]Underground up Pole
c0tesidentlal(Main)Service:
p0-100amps p101-150amps 0151-200amps Camps NofMeters
_
Gicommercial(Main)Service:
[]0-100 amps 13101-150amps 13151-200amps C3 _amps 0CTSerVICe_amps
Conductor Type Size
C310ulti-Famlly(Main)Service:
I3D-100 amps 0101-150amps ®151-200amps 0 amps 0 of Unit Meters
TEMPORARY POLE: 6u amps
❑SERVICE UPGRADE:[]_amps OCTSewice_amps
❑NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES, ETC-):
0100amps Ch50amps 0200amps ®_amps EX.TService_amps
❑ ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC:
Outlets/Switches:_0-30amps _31-3009mps _101-200amps
Appliances: _0-30amps _31-100amps _101-200amps
A/C Circuits: 0-60amps _61-100amps
Heat Circuits: _A circuits @_kw
Number of Lighting Outlets, Including Fixtures:
❑OTHER ELECTRICAL PROJECTS:
[]Swimming Pool OSign ❑5moke Detectors_(Qty) OTransformers KVA ❑Motors HP
FIRE ALARM SYSTEM(Requires 3 sets of plans):
Qty volts/amps
REPAIRS/MISCELLANEOUS:
[]Replace Burnt/Damaged Meter Can []Safety Inspection []Panel Change []OH to UG Updmedaoin/aa
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. 904 503-]055
Owner Name: RIVERSIDE HOMES Phone Number: ( )
Electrical Company. TRI COUNTY ELECTRICAL CONT INC. CfOce Phone. laoalsaaosee Fax.:ooai xeo-aene
Co.Address: 11637 EAST COLUMBIA PARK DRIVE _ �CCiuy: JACKSONVILLE State: FL Zip: 32250
License Holden KEVIN L. WEIR Sire Certlflca:Ion/Registration N'. EC13005421
Notarized Signature ofL Holder
x dged before me this lc[_tlay ci v .201X,In the State of Florida,County of buys 0
ozo Baa rsauWNVknaNlpepuog M g2 QA(I
0202'S pr suldx3 ww0
0 AW LL- Signature of Notary Public� 1r�:
SZOS66 ii is uonslwmop V
epppN to elelS-ollllnd AlelaR �a•,i Personally Known OR 13 Produced identification
lttld AWWtll ,,,;+e Type of Identification:
D ` RegisterCash Receipt • Number
City
f Atlantic Beach R7359
.r
77E
$s: 526 ATLANTIC BEACH CT APN: 1695051410 $9VICE 455-0000-322-1000 0 $35.00
SE FEE 955-0000.322-1000 0 $55.00
STATESURCHARGES $4.00
STATE DBPR SURCHARGE 6550000.208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000.208-0600 0 $2.00
TOTAL FEES PAID $94.00
Date Paid:Wednesday, November 14,2018
Paid By:TRI COUNTY ELECTRICAL
Cashier: BA
Pay Method:CREDIT CARD 6
Printed:Wednesday,November 14,20182:40 PM 1 of 1