550 Atlantic Beach Dr temporary pole permit `t) CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
9%' INSPECTION PHONE LINE 247-5814
ELECTRICAL TEMP POLE -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: TEMP17-0024
Description: TEMP POLE
Estimated Value: 0
Issue Date: 10/11/2017
Expiration Date: 4/9/2018
PROPERTY ADDRESS:
Address: 550 ATLANTIC BEACH DR
RE Number: 169505 1140
PROPERTY OWNER:
Name: TOUSEY CLAY B
Address: 2225 ALICIA LN
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: LORE ELECTRICAL CONTRACTORS
Address: 210 N ROSCOE BLVD 210 N. ROSCOE BLVD
PONTE VEDRA BEACH, FL 32082
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$7,500.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
P 904 2477576ax 904) 247-5845 E(V1
JOB ADDRESS: PERMIT #
/G
JEA INFORMATION REQUIRED ON ALL PERMITS � ) AMPS VOLTS PHASE
VALUE OF WORK S
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
❑Residential(Main)Service
110-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
❑M lti-Family(Main)Service
- 00-100 amps ❑1 1-150amps ❑151-200amps EJ amps #of Unit Meters
["Temporary Pole ❑amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps ❑200amps ❑ amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-3 Damps 31-l 00amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign El Smoke Detectors_Qty Transformers KVA El Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection El Panel Change 0O 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.
Property Owners Name / �� Phone Number
Electrical Company ��/'-E QP C . Office Phone Fax
Co.Address: ZVL� City State F Zip-?2ee2
License Holder(Print): State Certification/Registration#
Notarize _.
TONT GINDLESPERGER
r rY = MY COMMISSION#FF 9241efe me this/I day of 20
"Tz EXPIRES:October 6,2019
Bonded Thru Notary Public Underwr
-- ature of Notary Public