1673 Atlantic Beach TEMP18-0047 ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH TEMP18-0047
ISSUED: 12/4/2018
800 SEMINOLE ROAD EXPIRES:6/2/2019
ATLANTIC BEACH. FL 32233
ALL WORK MUST ROOM—
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
trctons applicable to this perty
NOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property
t m is from 0
d t hperro
I r En r u ired from other
that may be found in the public records of this county,,and there may be additional permits requ
I a ences
s I sC
governmental entities such as water management districts,state agencies,or federal agencies.
1673 ATLANTIC BEACH DR ELECTRICAL TEMP POLE $150.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP: ATLANTIC BEACH —
169505 1360 COUNTRY CLUB UNIT 02
-- E: ZIP:
COMPANY: ADDRESS: CITY: STAT —
TRI COUNTY ELECTRICAL 11637 E COLUMBIA PRK DR JACKSONVILLE FL 32258
E: ZIP:
OWNER: ADDRESS: CITY: STAT
LAURA COLEY
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR 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.
LIST OF CONDITIONS
Roll off Container company must be on City approved list. Container cannot be placed on City right-of-way.
FEES
DESCRIPTION
ELEC TEMP SERVICE 455-0000-322-10GO 0
ELECTRICAL BASE FEE 455-0000-322-1000 0
STATE DBPR SURCHARGE 455�208-0700 0 $2M
STATE DCA,SURCHARGE 455-�108�m 0 $2.CD
TOTAL:$94.00
Issued Date: 12/4/2018 1 of 2
"ALL INFORMATION
Electrical Permit Application HIGHLIGHTED IN
city of Atlantic Beach Building Department GRAY IS REQUIRED. —7
Boo Seminole Rd,Atlantic Beach, FL 32233 -elri
Phone: (904) 247-5826 Email: Building-Dept@coalOus PERMIT 9:
JOB ADDRESS: 103�AtaintIrt,Beash Drive ;PROJECT VALUE$_
JEA INFORMATION REQUIRED ON ALL PERMITS:(L—OAMPS ZYcvoLTs--L PHASE
NEW SERVICE: E3 overhead 13Underground 13Underground up Pole
c3flesidential [Mairl Service:
E30-100amps 0101-150amps 0151-200amps 13 amps #ofMeters-
13commercial(Main)Seri
[3o-loo amps E3101-150amps [3151-200amps E3—amps [3CT Service—amps
ConductorType Size
ciliflulti-Family(Main)Service:
[30-100 amps C3101-150amPs M51-200amps E3—amps #of Unit Meters
6EMPORARY POLE:_&n--amps
0 SERVICE UPGRADE:0—amps EXT Service—amps
F-1 NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES, ETC.):
0JODamps 13150amps 0200amps []-----amps 0:TServce—amPS
El ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC:
outlets/Switches: ____0-30amps _31-100amps 101-200amps
Appliances: ______9.30amps 31-100amps —101-200amps
A/C Circuits: .....0-60amps 1-100amps
Heat circuits: _#circuits @_kw
Number of Lighting Outlets, Including Fixturest
El OTHER ELECTRICAL PROJECTS:
[3SwjmmIng Pool 0SIgn amoke Detectors.(0ty) [3Transform,,.KVA []Motors.HP
F]FIRE ALARM SYSTEM (Requires 3 sets of plans):
city—volts/amps—
REPAIRS/MISCIELLANEOUS:
oReplace BurnVDam,g,d Meter can []Safety Inspection ElParelCharge E1OH to LES updated 10117118
Dther:
Id if work does not commence within a six month period orwork Is suspended or abandoned for six months. I hereby partly,that I have
Permit becomes yo at r
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 wh he
specified or not. The permit does not give authority to violate the provisions of any other state,lure law regulation construchlonitir the performance of
parestruption S Phmn,Nnmb,r (904)503-7055
Owner Name:
Electrical Company T, Comuty E vtri�aLc,,novfsi —off,cphsire Irs"i
Jacksaory lie State. FL Zip 32258
mT,l8P kD
Co.Address:'15dili Frost Cithin L 3r me City
EC1 3005421
W, c Cnr'
License Holds,:�Kevin L. % t a cerlifi,ation/Registration 0
Notarized Signature of License Holder
strum , .a c row a- 201 in the state of Florid.,I my of 6V
The foregoing instrument wasacknowledged before me this LI dayo
S grarture of Notary Pui AY1.1 arl Pat ji JL
TAMMY PALL I
Notary Public.State of Florida Pershorgally Known OR( I Produced Identification
conambelon*IF 995425 A
My Carl Expires Jul 6,2020 Type of identification:
Cash Register Receipt Receipt Number
City of Atlantic Beach R7522
DESCRIPTION ACCOUNT QTY PAI D
7Perm,tTRAK $94.00
TEMP18-0047 Address: 1673 ATLANTIC BEACH DR APN: 169505 1360 $94.00
ELECTRICAL $90.00
ELEC TEMP SERVICE 455-0000-322-1000 1 0 $35.00
ELECTRICAL BASE PEE 455-0000-322-1000 1 0 S55.w
STATE SURCHARGES
STATE DBPR SURCHARGE 455-0000-208-0700 1 0 $2.00
455-ODOO-208-0600 1 0 $2.00
STATE DCA SURCHARGE 4
iTOTAL FEES PAID BY RECEIPT: R7522 $94.00
Date Paid:Tuesday, December 04, 2018
Paid By:TRI COUNTY ELECTRICAL
Cashier: BA
Pay Method:CREDIT CARD 3
Printed:Tuesday,December 04,2019 2:18 PM 1 Of 1