831 Beach Ave TEMP23-0014 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
GRAHAM JAMES E 130 CLUB DR ATLANTIC BEACH FL 32233
COMPANY:ADDRESS:CITY:STATE:ZIP:
Tri County Electrical
Contractors (TRI COUNTY
ELECTRICAL)
11637 E COLUMBIA PRK DR JACKSONVILLE FL 32258
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
170330 0000 CLUB MANOR
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
831 BEACH AVE ELECTRICAL TEMP POLE Temp Pole 60 amps -
Overhead $22000.00
FEES
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
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
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.
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.
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.
1 of 2Issued Date: 6/6/2023
PERMIT NUMBER
TEMP23-0014
ISSUED: 6/6/2023
EXPIRES: 12/3/2023
ELECTRICAL TEMP POLE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
TOTAL: $94.00
2 of 2Issued Date: 6/6/2023
PERMIT NUMBER
TEMP23-0014
ISSUED: 6/6/2023
EXPIRES: 12/3/2023
ELECTRICAL TEMP POLE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
Electrical Permit Application **ALL INFORMATION,.
HIGHLIGHTED IN City of Atlantic Beach Building Department GRAY 1s REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 /i Id .::t:t:- _ \ Phone: (904) 247-5826 Email: Building-Dept@coab.us �ERMIT #: R /.:: 5 ';:).J-Ou I <o)
JOB ADDRESS: g 3 \ B �ch 4ve...PROJECT VALUE$ g.;;_,{}()6.aD
JEA INFORMATION REQUIRED ON ALL PERMITS: UJ...0D AMPS� VOLTS _j__ PHASE
� SERVICE:□ Overhead □Underground □Underground up Pole
c:Residential (Main) Service: □0-100 amps []101-lS0amps
[]Commercial {Main) Service: □0-100 amps O101-lS0amps
□1Sl-200amps ®amps # of Meters _j_
□1s1-2ooamps □. ___ amps C]CT Service ___ amps
Conductor Type _______ Size _____ _□Multi-Family (Main) Service:
[}HOO amps □101-lS0amps D151-200amps □___ amps # of Unit Meters __ _
(ovW\..\-\ec� 'T�� fole_)
0 SERVICE UPGRADE: O ___ amps 0::T Service ___ amps □ NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):□100 amps □lS0amps O200amps D ___ amps 0:T Service ___ amps
0 ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS, ACCESSORY STRUCTURES, ETC:
Outlets/Switches: ___ 0-30amps ___ 31-l O0amps ___ 101-200amps
App liances: ___ 0-30amps ___ 31-lOOamps ___ 101-200amps
A/C Circuits: ___ 0-60amps ___ 61-lO0amps
Heat Circuits: ___ #circuits @ ___ kw
Number of Lighting Outlets, Including Fixtures: __ _ □OTHER ELECTRICAL PROJECTS:
Dswimming Pool □Sign □smoke Detectors ___ (Qty) Drransformers ____ KVA □Motors ___ HP□ FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty ____ volts/amps ____ _ □ REPAIRS/MISCELLANEOUS:□Replace Burnt/Damaged Meter Can
O}ther:
□Safety Inspection □Panel Change OOH to UG
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 wi II 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. /\ • ,,. \ ·\ ['") \ ,;:;,3 LL l 7 3 7 Owner Name: � � \C.. JC a,e :(j lJ: \ .0/\.£:,Phone Number: _.J_· _T_-_______ _
Electrical Company:\ ,r:• L()Vf\ Y /3'/-eC,Office Phone: ___________ Fax: _____ _
Co. Address: Uo 3 2 UJ lvrn.h Pf -/[ City: iJJt X.., State: rfL-Zip: a.::3::2· ���
License Holder: t. \a, f\ c e.. ,,State Certification/Registration #: C:e.... I .,3 a I l 4
Notarized Signature of License Holder ���::'.'.::IC..::!....=�=-----------------------
The foregoing instrument was acknowledged before me this -1£..,day of £}vi\ f_ , 20:i...), in the State of Florida, County of s::,u-J ct.J...v
.. •·��•v°'•ii.•·•,,, TAMMY PALLff�\�\ Notary Public· State of Florida \�W�.! Commission# GG 981450 <r,o,,.�·· My Comm. Expires Jul b, 2024 Bonded through National Notary Assn.
Signature of Notary Public �� {?4L!2-t?
[�nally Known OR [ ) Produced Identification Type of Identification: _______________________ _
TEMP23-0014