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950 SAILFISH DR - TEMP POLE ' i1L , :r iii; S�� s• CITY OF ATLANTIC BEACH r > 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 \'''',4f;; � INSPECTION PHONE LINE 247-5814 ELECTRICAL TEMP POLE - MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: TEMP17-0018 Description: TEMP POLE Estimated Value: 0 Issue Date: 9/1/2017 Expiration Date: 2/28/2018 PROPERTY ADDRESS: Address: 950 SAILFISH DR 0 RE Number: 171167 0000 PROPERTY OWNER: Name: WILLOW FALLS LLC Address: 2221 ALICIA LN ATLANTIC BEACH, FL 32233-4219 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: MUNSON & BRYAN ELECTRICAL CO. Address: 3434 ST AUGUSTINE RD 3434 ST.AUGUSTINE RD JACKSONVILLE, FL 32207 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$7,500. ELECTRICAL PERMIT APPLICATION 1 CITY OF ATLANTIC BEACH 800 Seminole Rd,Atlantic Beach,FL 32233 em p cQ 1 Ph(904)247-5826 Fax(904)247-5845 'JOB ADDRESS: G‘ SO c c i,\f S V1. Di've- PERMIT# 1,7 - ©0 6° ;TEA INFORMATION REQUIRED ON ALL PERMITS I-10 AMPS oZ.'j o VOLTS (13 PHASE VALUE OF WORK$ Q.00 °* I. NEW SERVICE E Overhead ❑ Underground ❑T Underground up Pole ❑Residential(Main)Service i 00-100 amps 0101-150amps 0151-200amps 0 amps #of Meters ['Commercial(Main)Service 00-100 amps ❑101-150amps ❑151-200amps 0 amps OCT Service amps Conductor Type Size ❑Multi-Family(Main)Service geo-100 amps 0101-150amps ❑151-200amps 0 amps #of Unit Meters GYI'emporary Pole 0 L{n amps i SERVICE UPGRADE 0 amps 0 CT Service amps NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.) 0100 amps 0 150amps 0200amps 0 amps OCT Service amps ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC. • ' Outlets/Switches: 0-3Oamps 31-100amps 101-200amps ' Appliances: 0-3 Oamps 31-100amps 101-200amps • A/C Circuits: 0-60amps 61-100amps , Heat Circuits: # circuits @. kw • Number of Lighting Outlets, Including Fixtures: OTHER ELECTRICAL PROJECTS ll ['Swimming Pool 0 Sign 0 Smoke Detectors__Qty ['Transformers KVA ['Motors hp FIRE ALARM SYSTEM (Requires 3 sets of plans&Fire Alarm Checklist) I Qty volts/amps VALUE OF WORK$ REPAIRS/MISCELLANEOUS I ['Replace Bumt/Damaged Meter Can 0 Safety Inspection OPanel Change OOH to UG 0 Other: 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. Property Owners Name \d, 1,1p 1~f c r(A,5 1_L Phone Number `\0 9 317 Li 3 e.�t 1 Electrical Company (\A u►�Spn. 4— R fy AA 4_( rte Office Phone 3°t(.b62' 2-2-5Fax lo'( 324. -ll 34 Co.Address: 34 311 S+- AN.P3aSitr e- 9-.4 City M- State E Zip22-v7i License Holder(Print): 'So S 9A f„, - �� State Certification/Registration# c Loo 1 ri �v Notarized Signature of License Holder L • ti,'11 JOSEPH GUY CAUCHON o 'and subscribed befor me this day of 5 +- 20 j'7 �, '.r F?r ;7 CoExiSn3lssl y 1 FF 244825 C ���or` �!p+,�;;;� ExPfres July 16,2019 s tore of Notary Public t Bar.:Md.nuIcry Fain Inorm,63028S701i - -" ----. —...-'-- '---'-'-'- — ._ ,.s, ted✓• Cash Register Receipt Receipt Number City of Atlantic Beach R2440 DESCRIPTION ACCOUNT QTY PAID PermitTRAK $94.00 TEMP17-0018 Address: 950 SAILFISH DR APN: 171167 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 45500002080700 0 $2.00 TOTAL FEES PAID BY RECEIPT: R2440 $94.00 Date Paid: Friday, September 01, 2017 Paid By: MUNSON & BRYAN ELECTRICAL CO. Cashier: LE Pay Method: CREDIT CARD 3 Printed: Friday,September 01,2017 10:57 AM 1 of 1