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1955 Francis Ave TEMP21-0028 Temp Pole ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER CITY OF ATLANTIC BEACH TEMP21-0028 ISSUED: 12/10/2021 800 SEMINOLE ROAD ATLANTIC BEACH. FL 32233 EXPIRES: 6/8/2022 MUST CALL INSPECTION PHONE LINE (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: j VALUE OF WORK: 1955 FRANCIS AVE ELECTRICAL TEMP POLE Temp Pole: 50 Amps $500.00 TYPE OF REAL ESTATE BUILDING USE ZONING: SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 172101 0000 DONNERS S/D PT LOT 2 17- COMPANY: ADDRESS: CITY: STATE: ZIP: BEACHES ELECTRICAL GREEN COVE 214 COKESBURY CT FL 32043 SERVICES INC. SPRINGS OWNER: • ADDRESS: CITY: STATE: ; ZIP: LINWARD DEVELOPMENT CORPORATION 7002 EPPING FOREST TER JACKSONVILLE I L 32217 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. 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 455-0000-322-1000 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 Issued Date: 12/10/2021 1 of 2 ri' '�,J.,. , ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER '' '' TEMP21-0028 u tip:, . - r CITY OF ATLANTIC BEACH ISSUED: 12/10/2021800 SEMINOLE ROAD Oif1�r ATLANTIC BEACH, FL 32233 EXPIRES: 6/8/2022 TOTAL:$94.001 Issued Date: 12/10/2021 2 of 2 **ALL INFORMATION -\) Electrical Permit Application HIGHLIGHTED IN ,! \ 'j City of Atlantic Beach Building Department GRAY IS REQUIRED. ,, 1/; 800 Seminole Rd, Atlantic Beach, FL 32233 ,.. ';7`'•,, Phone: (904) 247-5826 Email: Building-Dept@coab.us 002,g PERMIT#: JOB ADDRESS: 1955 Fancis Ave PROJECT VALUE $$ 500.00 IEA INFORMATION REQUIRED ON ALL PERMITS: 200 AMPS 240 VOLTS 1 PHASE ri NEW SERVICE: ❑Overhead ❑Underground ❑Underground up Pole ©Residential (Main) Service: 00-100 amps 10101-150amps 0151-200amps ❑ amps # of Meters ❑Commercial (Main) Service: 00-100 amps 0101-150amps 0151-200amps 0 amps OCT Service amps Conductor Type Size ❑Multi-Family(Main) Service: ❑3-100 amps 0101-150amps 0151-200amps 0 amps # of Unit Meters ri TEMPORARY POLE: 50 amps SERVICE UPGRADE: ❑ amps ❑CT Service amps ❑ NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.): 0100 amps 0150amps D200amps 0 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: ri OTHER ELECTRICAL PROJECTS: :Swimming Pool Sign ❑Smoke Detectors (Qty) ❑Transformers KVA ❑Motors HP FIRE ALARM SYSTEM (Requires 3 sets of plans): Qty volts/amps n REPAIRS/MISCELLANEOUS: Replace Burnt/Damaged Meter Can ❑Safety Inspection Panel Change DOH to UG :Other: updated l0/17/18 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. Owner Name: XL Properties Phone Number: (904)304-3777 Electrical Company: Beaches Electrical Sefvice Inc. Office Phone: (994)629-3182 Fax:(9041406-0603 Co. Address: 214 Cokesbury Ct City: GCS State: FL Zip: 32043 License Holder: Todd Lockwood State Certi 'on/Registration #: EC13009644 Notarized Signature of License Holder ' _.gailit._ '� ,-- The .iThe foregoing instrument was acknowledged befo me •• • day of PEC. [ ] Personally Known OR [ Produced Identification tEC_ , 20 , •- State of Florida,ri � County of )7v VAL. Y° CHRISTIAN GILES Signature of Notary Public (� /`'V, � MY COMMISSION ti HH 117153 ,n: 117i �:` EXPIR6S:Apn113,2025 eO"OP Bonded ThnJNotary Pub4cUnderwriters Type of Identification: FL- }'- L _ t ' • aw • • • • r r. . • • t " ?"..3.11D 41AIT?$IHJ ,...;,,:-.S,`. 1 Ed t i t t tiH v,itot??tMMGD 1M . rossr litgA:2tiR19X3 p ;.`,: 1 zwrrionshaU a4dA rsio►9 we babtv,P .' 1 . W =