1067 BEACH AVE - TEMP POLE :�� tj
CITY OF ATLANTIC BEACH
s) 800 SEMINOLE ROAD
J--
CATLANTIC BEACH, FL 32233
;� � INSPECTION PHONE LINE 247-5814
ELECTRICAL TEMP POLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: TEMP17-0004
Description: 40 amps/240 volts/single phase-temporary pole
Estimated Value: 0
Issue Date: 5/16/2017
Expiration Date: 11/12/2017
PROPERTY ADDRESS:
Address: 1067 BEACH AVE
RE Number: 170267 0000
PROPERTY OWNER:
Name: MANDARIN EMPORIUM INC
Address: 2240 MAYPORT RD#7
IATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: KNIGHT ELECTRIC LLC
Address: 908 S 11TH AVE QA MARK STEVEN KNIGHT
JACKSONVILLE BEACH, FL 32250
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU 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.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
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CITY Of ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845 T L ytP l - OOOy
JOB ADDRESS: 1(:<, rea,C k a e_ PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS lit) AMPS NO VOLTS / PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead [] Underground ❑i Underground up Pole
iiResidential(Main)Service
00-100 amps E 101-150amps 151-200amps I'1 amps #of Meters
Commercial(Main)Service
0-100 amps 101-150amps 151-200amps amps CT Service amps
Conductor Type Size
Multi-Family(Main)Service
0-100 amps ,1101-150amps 151-200amps amps # of Unit Meters
Temporary Pole D amps
SERVICE UPGRADE amps CT Service amps
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 Cud_ 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 - VALUE OF WORK S
REPAIRS/MISCELLANEOUS
Replace 8urnt/Damaged Meter Can Safety Inspection Panel Change OH to UG
Other:
Permit becomes void if work does nut commence within a six month period or work is suspended or abandoned for six months. 1 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. an'
i /�Property Owners Name S hOde Phone Number
Electrical Company Vle-t c-1- �L t -e c if k. Office Phone "Dt- ) -G?88V Fax' k7 -12
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Co.Address: q0.37 I 1 `V21j • • City Z"-f., State p1.— Zip, a
.Lipenn Holder(Print):
( ) 512-rt � � f State Certification/Registration# �t 3c�(2 S�)
Notari = igR /aM+ fiv Holder �.
NOTARY POMO m ,
),.
.$TATE OF FLORIDA Sworn and subscribed before me this 1 of 1 I 'v`' 20
__ . . , Cant*F OWN
Expires 11112/2017 Signature of Notary Public
rs�Ly7�
Cash Register Receipt Receipt Number
r =)
\,...,,:::_j City of Atlantic Beach R1563
DESCRIPTION I ACCOUNT QTY PAID
PermitTRAK $94.00
TEMP17-0004 Address: 1067 BEACH AVE APN: 170267 0000 $94.00
ELECTRICAL $90.00
ELEC TEMP SERVICE 455-0000-322-1000 0 $35.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0700 0 $2.00
TOTAL FEES PAID BY RECEIPT: R1563 $94.00
Date Paid: Tuesday, May 16, 2017
Paid By: KNIGHT ELECTRIC LLC
Cashier: CT
Pay Method: CREDIT CARD 014053
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Printed:Tuesday, May 16,2017 12:41 PM 1 of 1
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