309 PLAZA TEMP24-0005 I. ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
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CITY OF ATLANTIC BEACH TEMP24-0005
800 SEMINOLE ROAD ISSUED: 2/22/2024
�Di3J9r V ATLANTIC BEACH, FL 32233 EXPIRES: 8/20/2024
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: VALUE OF WORK:
309 PLAZA ELECTRICAL TEMP POLE TEMP POLE $1200.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169990 0000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
DUVAL ELECTRIC LLC 2109 1ST STREET SOUTH JACKSONVILLE FL 32250
BEACH
OWNER: ADDRESS: CITY: STATE: ZIP:
STEVEN AND REBECCA
GOLDWASSER REVOCABLE 8483 STABLES RD JACKSONVILLE fl 32256
TRUST
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.
7DESCRIPTION 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 $2.00
Issued Date:2/22/2024 1 of 2 __.�W
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Electrical Permit Application **ALL INFORMATION
HIGHLIGHTED IN
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i' City of Atlantic Beach Building Department GRAY IS REQUIRED.
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\-). ) 800 Seminole Rd, Atlantic Beach, FL 32233 1 --rrleZ4 — o cx.DES
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: R E S 23-002..(
JOB ADDRESS: 30 ck 1..$), a, PROJECT VALUE $ 12D
JEA INFORMATION REQUIRED ON ALL PERMITS: /0 D AMPS 240 VOLTS i PHASE
NEW SERVICE: Overhead Underground ❑Underground up Pole
Residential (Main) Service:
0-100 amps E101-150amps 151-200amps r, amps #of Meters
Commercial (Main) Service:
-0-100 amps o101-150amps x151-200amps ri amps ECT Service amps
Conductor Type Size
i ;Multi-Family(Main) Service:
0-100 amps E101-150amps H151-200amps r 1 amps #of Unit Meters
11 TEMPORARY POLE: 400 amps
SERVICE UPGRADE: ❑ amps :CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
.100 amps L_150amps [ 200amps amps :CT Service amps
I I ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 0-30a mps 31-100amps 101-200am ps
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 L Smoke Detectors (Qty) -Transformers KVA Motors HP
FIRE ALARM SYSTEM (Requires 1 set of digital plans):
Qty volts/amps
REPAIRS/MISCELLANEOUS:
[]Replace Burnt/Damaged Meter Can LSafety Inspection Panel Change [ 10H to UG
❑Other: updated 10/11/23
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. Q�
Owner Name: (i��� �
�D� [vciSSPJl Phone Number: - Z33 �Q,p
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Electrical Company: DV Vq / c J1 e c ri L CSL C.-Office Phone: '1O'-( -SIJ - eeq Fax:
Co.Address: .? ► O GI it S# Si-- -S City: J We ,8 ea r-2,, State: FL Zip: .32:22-3-0
License Holder: ,flit"` cbj).-04..F-0l r State Certification/Registration#: EC /300 12.. .e2_
Notarized Signature of License Holder �'v
The foregoing instrument was acknowledged before me this??da .of _PE b , 02 he State of Florida,County of
Signature of Notary Public
,: PersonallyKnown OR Produced Identification
c��.� �"�r�. TONT GINDLESPERGER [ ] [ ]
_. ` :- MY COMMISSION#HH 407122 Type of Identification: _
EXPIRES:October 6.2027
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