195 Seminole Rd temp pole permit y n, CITY OF ATLANTIC BEACH
i 800 SEMINOLE ROAD
ATLANTIC 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: TEMP17-0012
Description: TEMP POLE
Estimated Value: 0
Issue Date: 7/24/2017
Expiration Date: 1/20/2018
PROPERTY ADDRESS:
Address: 195 SEMINOLE RD
RE Number: 170604 0000
PROPERTY OWNER:
Name: MICROBIAL NATURAL PRODUCTS INC
Address: 1207 SEMINOLE RD
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: BARKOSKIE ELECTRICAL SERVICE,
Address: 48 S PENMAN RD INC.148 S. PENMAN ROAD
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$7,500.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233 _
Ph(904);2247-5826 Fax (904)247-5845 1 Eft P 1-7- bO I
JOB ADDRESS: Sexp'goL.E K-a) -TP F ft. PERMIT 4
JEA INFORMATION REQUIRED ON ALL PERMITS I o0 AMPS ZAV VOLTS I PHASE
o�
,..�,/ VALUE OF WORRS ��
�
NEW SERVICE t...7 Overhead ❑ Underground ED Underground up Pole
Residential(Main)Service
0-100 amps 1101-150amps 1 151-200amps i amps #of Meters
Commercial(Maio)Service 'CT Service amps
0-100 amps Ii101-150amps 151-200amps -amps —
Conductor Type Stu
Multi-Family(Main)Service
0-100 amps 11101-150amps : 1151-200amps amps #of Unit Meters
Temporary PoletpL�_amps
SERVICE UPGRADE amps CT Service_amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
100amps I1150amps 200amps amps CT Service—amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Applians: 0-30amps 31-100amps 101-200amps
f ceA/C Circuits: 0-60amps 61-100=ps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
Swimming Pool Il Sign I lSmoke Detectors_Qty 'Transformers KVA ' Motors_hp
FIRE ALARM SYSTEM (Requires 3 who of plass) VALUE OF WORL$
Qty_volts/amps
REPAIRS/MISCELLANEOUS
Replace Bumt(Damaged Meter Can Safety Inspection Panel Change -OH to UG
Other:
Permit becomes void ifwmk does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that 1 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 m not The pemlit does not give authority to violate the provisions of any other state m local law regulation construmlon or the perforoance of
construction. ' \ 6,54- 42-++
,I
Property Owners Name M N ` I Phone Number 6,54- 4�+
Electrical Company— IGO75K.tE -t�CfisO C_ C. Office Phone 241,473/ Fax..241-20117
Co.Address: 9,53 SaeTUE2 A- City -)A-jc 75.--14 State ft_- Zip 37Z
Lkeoae Holder(Print): —� �G State Certification/Registration OF 3�L 387
Notarized Signature ofLicrnse Holder I A'
L� ��
CEBeforemethis Meday of 2017alaoSignature of Notary Public '- -01]