1280 W Plaza TEMP POLE 1=`'''',' ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
��' \`' CITY OF ATLANTIC BEACH TEMP18-0050
� ,�r ISSUED: 12/26/2018
800 SEMINOLE ROAD
```-'�'»`° ATLANTIC BEACH. FL 32233 EXPIRES: 6/24/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
NOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property
that may be found in the public records of this county, and there may be additional permits required from other
governmental entities such as water management districts,state agencies,or federal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1280 W PLAZA ELECTRICAL TEMP POLE TEMP POLE $250.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170979 0000 ATLANTIC BEACH SEC H
COMPANY: ADDRESS: CITY: STATE: I ZIP:
KNIGHT ELECTRIC LLC JACKSONVILLE FL 32250
BEACH
OWNER: ADDRESS: CITY: STATE: ZIP:
BROWN JAMES W 4012 RUSTLING OAKS CT JACKSONVILLE FL 32277
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.
i LIST OF CONDITIONS
Roll off container company must be on City approved list. Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
ELEC TEMP SERVICE 455-0000-322-1000 0 $35.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $94.00
Issued Date: 12/26/2018 1 of 2
-•./YE. ..ii‘L .1%L I rauraal 4ix-nu1l..AA1VPl
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph (904)247-5826 Fax (904) 247-5845 EMP l 8 - o O5O
JOB ADDRESS: 070 &t—ST PAZA- PERMIT# NES/1"Dl
JEA INFORMATION REQUIRED ON ALL PERMITS 140 AMPS 240 VOLTS i PHASE
VALUE OF WORK$ a
NEW SERVICE ❑ Overhead 0 Underground D Underground up Pole
EResidential (Main) Service
1.J0-100 amps J I01-150amps El 151.200amps amps # of Meters
Li Commercial(Main) Service
10-100 amps E101-150amps C 151-200amps 11 amps I ICT Service amps
Conductor Type Size
!Multi-Family(Main) Service
0-100 amps , '101-150amps E 151-200amps I 1 amps # of Unit Meters
lirTemporary Pole ,- IP amps
SERVICE UPGRADE 1"1 amps Ll CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
:100 amps J 150amps U200amps 41 amps I iCT 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 El Sign 1"Smoke Detectors._Qty (Transformers KVA .:Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
! 'Replace Burnt/Damaged Meter Can I :Safety Inspection i::Panel Change :OH to UG
1.1 Other:
Permit becomes void it'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. g
Property Owners Name
r�� phone Number
Electrical Company / iSI1 r C‘'t-Tr1`e- &LL _Office Phone VI/7-9 FINFax
Co. Address: O3. (l t` ': 5 City TP-11 rkk State r 1, Zip 311-W
License Holder(Print): 517YCr: KM011 State Certification/Registration# &Albe2f y
Notarized Signature of License Holder qr—
I ..4r,. .) Notary PEbacL State of Florida EAtANISER 0 Sworn and subscribed before me t 's 20 a y of % iC--- —20i
+ Commission N Gt t f Floc
4 oor;:) TMy comm.Expires May 3t,!020 I Signature of Notary Public J..t I.,. II 1. ,1 R.I 1
1 aondea through National Notary Assn. I / '
Receipt Cash Register Receipt Rt Number p
'51W,
1City of Atlantic Beach R7708
DESCRIPTION I ACCOUNT QTY PAID
PermitTRAK $94.00
TEMP18-0050 Address: 1280 W PLAZA APN: 170979 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 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R7708 $94.00
Date Paid: Wednesday, December 26, 2018
Paid By: KNIGHT ELECTRIC LLC
Cashier: LE
Pay Method: CREDIT CARD 3
ors
Printed:Wednesday, December 26,2018 2:29 PM 1 of 1
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