362 Plaza temporary pole permit ri�L`J f v
CITY OF ATLANTIC BEACH
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: TEMP18-0001
Description: 60 amps/240 volts/single-phase-temporary pole
Estimated Value: 100
Issue Date: 1/23/2018
Expiration Date: 7/22/2018
PROPERTY ADDRESS:
Address: 362 PLAZA
RE Number: 169972 0005
PROPERTY OWNER:
Name: MERRIAM RICHARD A
Address: 4451 MENDENHALL DR
DALLAS, TX 75244
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: Atlantic Coast Electrical Contractors, Inc.
Address:
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$7,500.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
( / Ph(904)247-5826 Fax(904) 247-5845 7L Alt() ( ' �?C)
JOB ADDRESS: T' P` `t Z PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS �e G AMP436ifo VOLTS PHASE
VALUE OF WORK$ A)d V
NEW SERVICE Overhead ❑ Underground ❑i Underground up Pole
❑Residential(Main) Service
❑0-100 amps ❑101-150amps ❑151-200amps LI-amps #of Meters
❑Commercial(Main)Service
❑0-100 amps ❑101-150amps ❑151-200amps El-amps ❑CT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
❑0-100 amps ❑101-150amps ❑151-200amps El-amps #of Unit Meters
KTemporary Pole ❑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-l 00amps 101-200amps
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 ❑Smoke Detectors_Qty ❑Transformers KV A Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
[]Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG
[]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. n
Property Owners Name m e�I p`t �` '`�e Phone Number
Electrical Company �TL/�t n C- 9 Office Phot —l") rFax-
Co.Address: ®' b -�d�` Z7 Z City State P- Zip 3.)-ZY 0
License Holder(Print): State Certification/Registration Pre-13 .c7 7dfr 2--
Notarized
Notarized Sir Holder ,{
• •Y P(••• R JOHNSON al da of `1 a gq�I 204
MY COMMISSION#GG 042984
Sworn and subscribed before me this
Er `' EXpIRES:October 27,2020
.°` ru Notary Public UndenMiters
Bonded Th Signature of Notary Public
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