533 Atlantic Beach Ct TEMP18-0045 ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH TEMP18-0045
800 SEMINOLE ROAD ISSUED: 11/19/2018
' ATLANTIC BEACH. FL 32233 EXPIRES:5/18/2019
Izi—
• • • • • • • • t • • • • •
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.
• • ADDRESS:
DESCRIPTION: VALUE OF WORK:
533 ATLANTIC BEACH CT ELECTRICAL TEMP POLE $190,00
ZONING:TYPE OF REALESTATE BUILDING USE
CONSTRUCTION: NUMBER: SUBDIVISION:
169505 1420 ATLANTIC BEACH
COUNTRY CLUB UNIT 02
COMPANY: DD.
UNITED ELECTRIC
COMPANY OF 5716 SAINT AUGUSTINE ROAD JACKSONVILLE FL 32207
JACKSONVILLE
• ADDRESS: CITY: STATE: ZIP
ROICKJAMESA 2228 OCEANWALK DR W ATLANTIC BEACH FL 32233
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 SEflVICE 455-0000-3221000 0
$35.00
ELECTRICAL 60.5E FEE 455-0000.322-1000 0 $5500
STATE DBPR SURCHARGE 455-0000306-0700 0 $200
STATE DCA SURCHARGE 455-0000-2080600 0 $2M
Issued Date:11/19/2018 1 oft
ELECTRICAL TEMP POLE PERMIT PERMITNUMBER
CITY OF ATLANTIC BEACH TEMP18-0045
800 SEMINOLE ROAD ISSUED: 11/19/2018
i� u> ATLANTIC BEACH. FL 32233 EXPIRES:5/18/2019
TOTAL:594.00
Issued Date:11/19/2018 2 of 2
ELECTRICAL PERMIT APPLICATION 'T - 19 y i
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
Ph(904)24p77-5826 Fax(904)247-5845. RES ( $ - 035y
JOBnADDRESS: 533 Llai'L OLaG1, Cf" TP-0I PERMIT#
em Plg�- W �
JEA INFORMATION REQUIRED ON ALL PERMITS _1_0 AMPS ? y,7 VOLTS 'I PHASE
-VALUEOFWORK3 190. 9-
NEW SERVICE ❑ Overhead 47oderground ED Underground up Pole
❑Residential(Main)Service
00-100 amps 13101-150amps 0151-200amps ❑ amps #of Meters
❑Commercial(Mala)Service —
00-100 amps 0101-150amps 0151-200amps ❑- amps DCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service-
D0-100steps. ._ 0101-150amps 0151-200amps ❑ amps #of Unit Meters
Temporary Pole D (/ O amps
SERVICE UPGRADE ❑ amps ❑ CT Service_amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100amps 0150amph 11200amps ❑ amps CCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 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 seta of plans&Fire Alarm Checklist)
Qty volts/amps VALUE OF WORK S
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change DOH to UG
❑other:
Permit becomes void ifwork does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that 1 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 Ortho performance of
construction.
Property Owners NameoC e-pKi �umrs /+ Phone Number tY13
Electrical Company U; +e C Olc fn i_ G Of J4,`f Office Phone-7 3/- V Z/0 Fax`131-53
Co.Address: 57i (, 7A 1ui :ti Zit City Suek.So4 ,*)k State�Zip322a7
LicenseHolder(Print): N a4 State Certification/Registration# EC1300 53(r7
Notarized Signature of License HolderII
Sworn and subscribed before m this day o J k e'qtr 20)'T
=11RENDA E"IRES AM]23,2022 N86 Signature of Notary Public