388 11TH ST - TEMP POLE .'i%-Lyr
:, ' • `. CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
I ost !.) INSPECTION PHONE LINE 247-5814
ELECTRICAL TEMP POLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: TEMP18-0002
Description: 60 amps/240 volts/single-phase-temporary pole
Estimated Value: 0
Issue Date: 1/25/2018
Expiration Date: 7/24/2018
PROPERTY ADDRESS:
Address: 388 11TH ST
RE Number: 170092 0000
PROPERTY OWNER:
Name: COHEN GREGORY M
Address: 184 TUSCANY BEND ST
DAYTONA BEACH, FL 32117
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
,
Phone:
Name: ALLSTATE ELECTRICAL CTR INC.
Address: P 0 BOX 550617 P.O. BOX 550617
JACKSONVILLE, FL 32255
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$7,500.
a4rP/ ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
Ph (904)247-5826 Fax(904)247-5845 /
JOB ADDRESS: -581— 114/L PERMIT# /7-440/6./
JEA INFORMATION REQUIRED ON ALL PERMITS _ (D AMPS 7 VOLTS r< PHASE
VALUE OF WORK$ l-.,
NEW SERVICE ❑ Overhead Underground tr Underground up Pole
❑Residential(Main)Service
00-100 amps ❑101-150amps ❑151-200amps amps #of Meter., .
❑Commercial(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
[ 1 emporary Pole ❑ Gl) amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps ❑200amps ❑ amps OCT 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 @ 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&Fire Alarm Checklist)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change DOH 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. ` f7 �7
Property Owners Name C[)e g A c Phone Number 5oS�"477"6777
Electrical Company_DJ �c.I. ,� s.r Office Phone -AIL--z. Fax �-�/
Co.Address: Agra' Cyr l s rC City L t.�, State Zip722
!/
License Holder(Print): (/.9/-)74t-s '"4/ W State Certification/Registration# 3
Not rued Signature n License Holder 900,04! e-
"'"' ': DAE.BSworn and subscribed before Z$ j
" day of 20 L
Jtr !k
744! EXPIRES: 19 ..ders Signature of Notary Public