355 W 3RD ST TEMP19-0004 TEMP POLE PERMIT ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH TEMP19-0004
800 SEMINOLE ROAD ISSUED: 1/24/2019
�+ ATLANTIC BEACH. FL 32233 EXPIRES: 7/23/2019
MUST CALL INSPECTION •NE LINE (904) 2• , BY 4 PM FORDAY •
ALL • ' K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' ! + BUILDING
• ! AND CITY OF ATLANTIC + CH CODE OF ORDINANCES .
ALL • ! • OF APPLY, PLEASE ! 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.
• : + •N: VALUE OF •
355 W 3 ST ELECTRICAL TEMP POLE TEMP POLE $5000.00
TYPE OF
i • GROUP:
170873 1000 ATLANTIC BEACH SEC H
COMPANY: ADDRESS: '
HUNTER ELECTRIC 11624 DAVIS CREEK ROAD EAST JACKSONVILLE FL 32256
COMPANY
• ADDRESS:
BEASLEY GERALDINE ET AL 237 SOUTHERN ROSE DR JACKSONVILLE FL 32225
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 i .
iRoll 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 45S-0000-208-0600 0 $2.00
TOTAL: $94.00
Issued Date: 1/24/2019 1 of 2
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233 /I
22 Ph(904)247-5826 Fax(904)247-5845 1 Em P I c) - o oc)4
JOB ADDRESS: . :5 S5 W 3(p 3. PERMIT# �5 11-C)5 8 S
JEA INFORMATION REQUIRED ON ALL PERMITS PW AMPS A U VOLTS � PHASE
VALUE OF WORK$ 5,7000• 0'6
NEW SERVICE ❑ Overhead Underground .IJnderground up Pole
❑Residential(Main)Service
00-100 amps ❑101-150amps 151-200amps ❑ oZOV amps #of Meters
❑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
Temporary Pole(p 0 amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps ❑ 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)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH 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 JC 3 �p ,� Phone Number
1
Electrical Company "d, EAec-A.r_ Office Phone At r•14195 Fax � • Co 13
Co.Address: 111s94 Crtc It Ity � State '( Zip
License Holder(Print): State Certification/Registration#EC Ow-2 35 0
Notarized Signature of License Holder
REBECCA RUSH Before me this �n day 20 �ai
Notary Public,State of Florida
My Comm.Expires 07/12/21 Signature of Notary Publi
Commission No.GG101570