394 Sargo Rd TEMP21-0027 Temp Pole rs' '' ��. ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
�„��-� TEMP21-0027
1 J , CITY OF ATLANTIC BEACH ISSUED: 12/8/2021
800 SEMINOLE ROAD
��`' ' � ATLANTIC BEACH, FL 32233 EXPIRES: 6/6/2022
MUST CALL INSPECTION PHONELINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
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:
394 SARGO RD ELECTRICAL TEMP POLE Temp Pole: 50 Amps $250.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171692 0000 ROYAL PALMS UNIT
02A3.00
COMPANY: ADDRESS: CITY: STATE: ZIP:
SEASIDE ELECTRICAL 12620-3 Beach Blvd #235 JACKSONVILLE FL 32246
CONTRACTORS
OWNER: ADDRESS: t CITY: : STATE: ZIP:
** CONFIDENTIAL ** ** CONFIDENTIAL ** ** CONF ** XX #####
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.
I
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
ELEC TEMP SERVICE 455-0000-322-1000 0 $35.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$94.00
Issued Date: 12/8/2021 1 of 2
ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH TEMP21-0027
800 SEMINOLE ROAD ISSUED: 12/8/2021
ATLANTIC BEACH, FL 32233 EXPIRES: 6/6/2022
Issued Date: 12/8/2021 2 of 2
e„,,,„,,,,,- Electrical Permit Application **ALL INFORMATION
HIGHLIGHTED IN4i ,.....,
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
``'�''`�� Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: ti Li. / k G ,c PROJECT VALUE $ 2:5C-). '
JEA INFORMATION REQUIRED ON ALL PERMITS: '5-O AMPS Zyc VOLTS / PHASE
❑ NEW SERVICE: ❑ Overhead ❑Underground Underground up Pole
❑Residential (Main)Service:
70-100 amps 7101-150amps o151-200amps ❑ amps #of Meters
Commercial (Main) Service:
❑0-100 amps o101-150amps o151-200amps ❑ amps ECT Service amps
Conductor Type Size
❑Multi-Family(Main) Service:
❑0-100 amps o101-150amps o151-200amps ❑ amps #of Unit Meters
1 / 1 TEMPORARY POLE: C' amps
SERVICE UPGRADE: amps nCT Service amps
I I NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
100 amps 150amps 200amps amps ❑CT 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 sets of plans):
Qty volts/amps
REPAIRS/MISCELLANEOUS:
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change DOH to UG
Other: Updated 10/17/18
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. A .(-j ) f
Owner Name: 1 I -��R/'� � r`t'► 3 A ,41,J Phone Number:
Electrical Company: 6;/4-Si d1Q /a1le G i'c/a' [ e - Office Phone: 70�� /`I - OC3C Fax:
Co.Address: X26 Z() ` 3 ;gene^^ 1a/✓) i2.?� City:.-TAC-1(—C1-0 0,- Ji (le State: i'-t- Zip: 37-2-Y6
License Holder: 04(2K 6-e.--2-(5--s-"" State Certification/Registration#: L /3v / ?5-7g
Notarized Signature of License Holder
The foregoing instrument was acknowledged before me this day of D(;R. ,202.1, in the State of Florida,County of DU vittL
011/A/5-11‘...,..
CHRISTIAN GILES Signature of Notary Public / /
��� *: MYCOMMISSION#HH117153
• t▪ it [ ] Personally Known OR[�.raduced Identification
EXPIRES:April 13,2025
tifr:f Op• Bonded Thy Notary Public Undereilers Type of Identification: