778 Vecuna Rd TEMP19-0001 temp pole permit ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
-0001
CITY OF ATLANTIC BEACH TEMP19
800 SEMINOLE ROAD ISSUED: 1/15/2019
EXPIRES: 7/14/2019
ATLANTIC BEACH. FL 32233
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:
778 VECUNA RD ELECTRICAL TEMP POLE 100 amps/240 volts/single- $450.00
phase - temporary pole
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1713530000 ROYAL PALMS UNIT 02A
COMPANY: ADDRESS: CITY: STATE: ZIP:
Creekside Electrical 44449 Woodbridge Dr Callahan FIL 32011
Consulting LLC
OWNER: ADDRESS: CITY: STATE: ZIP:
Porter Mason 1340 Trailwood Drive Neptune Beach FL 32266
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.
0
DESCRIPTION ACCOUNT QUANTITY PAIDAMOUNT
ELEC TEMP SERVICE 455-0000-322-1000 0 $35.00
ELECTRICAL BASE FEE 4SS-0000-322-10 0 0 $55.00
STATE DBPR SURCHARGE 4S5-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 1 0 1 $2.001
TOTAL:$94.00
Issued Date: 1/15/2019 1 of 2
ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
TEMP19-0001
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 1/15/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 7/14/2019
Issued Date: 1/15/2019 2 of 2
Electrical Permit Application "ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 L ILA-
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS:—:I -� � V P— Lu Ktpl EL) PROJECT VALUE$ Li I5061L-
JEA INFORMATION REQUIRED ON ALL PERMITS: W AMPS ,)
�VOLTS PHASE
NEW SERVICE: 0 Overhead l7lUnderground []Underground up Pole
E311esidential (Main)Service:
[10-100 amps 0101-150amps [1151-200amps 0—amps #of Meters
[)Commercial (Main)Service:
[30-100 amps 0101-150amps 13151-200amps 13 amps []CT Se ry ice_a m ps
Conductor Type Size
OMulti-Family(Main) Service:
[10-100 amps [1101-150amps [1151-200amps [3—amps #of Unit Meters
FVITEMPORARYPOLE: IW amps
EISERVICE UPGRADE: El— amps OCT Service amps
F� NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
C3100amps [1150amps []200amps []_amps aTService_amps
L1 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:
DSwimming Pool DSign E]Smoke Detectors (Qty) OTransformers KVA E]Motors HIP
F-] FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
F] REPAIRS/MISCELLANEOUS:
[:]Replace Burnt/Damaged Meter Can E]Safety Inspection E)Panel Change E]OH to UG Updated 10/17118
[3)ther:
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' cfpq- -7-7
Owner Name: 0'rx-� PC Phone Number: 314-4 1
Electrical Company: C-rp PtS'tak E�t�V-r:1CLA CMSu�Wffice Phone: 9014- 30 S-'94 94 —Faxi-.-
Co.Address: Lk�OD&-�,At�vt City: —State: R zip: 3Aml
License Holder: Lz�r -Wvpw�� State Certification/Registration 4:
Notarized Signature of Lkense Holder
The foregoing instrument was acknowledged before me this_L�_clay of 3e�nua:fq 20,LcL in the State of Florida,County of
.40 A% Notary Pubirc State ca)f Fk>xn�da ignature of Notary Public
R IN Paula J Pierce
My Corrvniu*n GG 280497
Expir"10115/2022 [vj Personally Known OR Produced Identification
�yyap) ^^0% Type of Identification:
Cash Register Receipt Receipt Number
City of Atlantic Beach R7844
DESCRIPTION ACCOUNT CITY PAID
7 PermitTRAK $223.00
ERES19-0018 Address: 778 VECUNA RD APN: 171353 0000 $129.00
E
LECTRICAL $125.00
ELECTRICAL BASE FEE 455-0000-322-1000 $55.00
ELEC NEW SINGLE FAMILY 455-0000-322-1000 200 $70.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0�� 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TEMP19-0001 Address: 778 VECUNA RD APN: 171353 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 SU RCHARG E 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R7844 $223.00
CITY OF AT[WIC BEACH
800 SEIVINCLE RD
ATLANTIC BEAC,FL 32233
0 1�15,2019 11:09:29
CREDIT CARD
VISI,SALE
Card XXXXXXX=9588
SEQ 2
Bath 771
INVOICE 2
Approval Code: 078BOG
Entry Method: Manual
Mode: Onlhe
Tax Amount: p.00
Card Code: M
SAIE AMOUNT $2231
Date Paid:Tuesday,January 15, 2019
Paid By: Creekside Electrical Consulting LLC CUSTOMER COPY
Cashier: BA
Pay Method: CREDIT CARD 2
Printed:Tuesday,January 15,2019 11:11 AM 1 of 1