2060 Beach Ave - Early Power r 4 EARLY POWER AGREEMENT & l t LEASE
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CITY OF ATLANTIC BEAC l i
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Electric power is requested now under the conditions and terms of this fully executed Agreement& Release
Job Address: 2D l Q tC t� 22-215 5
Permit No. t V [-LEc-- 12 v9 Service Type(Circle One): Overhead Jnderground
We,the undersigned General Contractor and Electrician,understand and agree:
1. "Early Power" is purely for our construction convenience, it is not required by Codes and does not
substitute for Final-Inspections or the C/O(Certificate of Occupancyjhiat must be issued before occupancy,
and as such is at the discretion of the Building Official.
2. The City of Atlantic Beach will make a special inspection prior to the curly power energizing. All rough
inspections must have prior Approval, including meter base connections.
3. Occupancy or use of the new construction before a formal C/O constitutes fraudulent use of the early
electric service. Such action is expressly prohibited and penalized "y The City of Atlantic Beach
Ordinances. A violation of this Agreement shall result in a request for p' )mpt removal of electric service
after a twenty-four hour notice.
4. "Early Power"release authority is the Electrician and/or the Contractor and must not occur before:
a. Equipment,devices and fixtures are installedor blanked off)safely.
b. Panel is complete with breakers and cover,and(labeling required at final inspection).
c. Service connection and grounding is complete.
d. The electric system has safely passed through electrical check.
e. Meter can is permanently marked with address.
f. Temporary address numbers displayed(Permanent numbers are required for C/O).
5. This fully completed form is to be submitted to the Building Department hand,mail or fax.
6. Future such Agreements will not be accepted from those who violate any one of the above items.
•
CONTRACTOR CI GI ' r i(t( j DATE. i - 2
PRINT NAME C VG w 1rrd Ela:tr (A � C Un1Yac+i
ELECTRICIAN J @hn CI of vv L DATE — Z `�
PRINT NAME ,Joh() Cyci w fo rd
Ec- 13oo 2t04ct
800 Seminole Road,Atlantic Beach FL 3223
Phone:(904)247-5826 Fax:(904)247-5845 http://www.coab.:s revised 01 30 09
Permit number / eicz. • /Z N9
BUILDING INSPECTION DIVISION
CITY OF JACKSONVILLE, FLORIDA
Temporary Service Letter for Emergency JEA Reconnect
I respectfully request that temporary power for the address listed below be restored. I acknowledge by my
notarized signature below that I will be responsible for anything that may occur due to the energizing of the
service prior to the final electrical inspection. /
Address of repair % C0 ,i2/,•ch A ve /'�r c ><3:/ 4.
Nature of repair R e_ (7ecf e'ro .
Required action from JEA: (please check one below)
❑ Re-tap at JEA pole 0 Re-tap at the building 0 Replace meter
Re-tap at transformer. What is the transformer number?
❑ Replace line drop. How long is the line drop in feet?
Company Name CPA c1 I61erl,rir
Contact person & phone number Z•3110) e n,JJ 1 70` 3-, c6
Telephone Number( ) Zyi-S',S"y/ Fax number(9o,/ ) 2'i/ —903 7
Email address C,.a�,� „1�( ��,z e e. H
Qualifying agents name (print) �o .) 1 IfA a Poi•.1
Qualifying agents Signature (' dnZz;e•A: ---- Date
Before me this 2 day of U V In the County of Duval.
State of Florida has personally appeared(print) jO_I `C6
'
Herein by himself/ • self ani ffir s a statements a • ••clarations herein are true and accurate.
JC Di RICHMOND
Notary signature Ali row _ / w
i 1 �� " a. i MY COMWISSI0N t FF 977570
iia :di EXPIRE. March 31.2020
Notary Public at Llre. . ate of County of D uVQ
'•:!?.i�;�� Rorded TAru ..•c.3ry Public Underwriters
Personally known ID E Cl 010-2-1:1-1-9
Electrical Department contacts: We prefer that you email this form to all three of us.Jimmy Douglas, Electrical Dept.
Supervisor 904-255-8567 jdouglas@coj.net Rick Taylor, Assistant Electrical Dept. Supervisor 904-255-8565
rataylorq.koj.net Ricky Smith front Counter 904-630-1 100 opt.4 rickys@coj.net fax 904-255-8553
PLANNING and DEVELOPMENT DEPARTMENT 214 N.Hogan Street,Room 273 Jacksonville,FL 32202 Phone:904.630.1100 Fax:
904.255.8553 www.coj.net