1 Fleet Landing Blvd TEMP19-0008 temporary pole permit ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH TEMP19-0008
800 SEMINOLE ROAD
ISSUED: 2/12/2019
ATLANTIC BEACH, FL 32233 EXPIRES: 8/11/2019
MUST CALL INSPECTION • 914 247-5814 BY , PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • '
CODE, OF BEACH CODEOF 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:
1 FLEET LANDING BLVD ELECTRICAL TEMP POLE 200 amps/208 volts/third $5000.00
5700 phase -temporary pole
TYPE OF
ZONING: :D •
• • GROUP:
169397 0200 SECTION LAND
COMPANY: ADDRESS:
OWEN ELECTRIC CO INC 1775 LAKESIDE AVE ST.AUGUSTINE FL 32084
• ADDRESS:
NAVAL CONTINUING CARE
RETIREMENT 1 FLEET LANDING BLVD ATLANTIC BEACH FL 32233-4599
FOUNDATION INC
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 . . •
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
Issued Date:2/12/2019 1 of 2
ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
CJs r >
CITY OF ATLANTIC BEACH TEMP19-0008
800 SEMINOLE ROAD ISSUED: 2/12/2019
rs �` ATLANTIC BEACH. FL 32233 EXPIRES: 8/11/2019
TOTAL:$94.00
Issued Date:2/12/2019 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
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: F&Ajoig
JOB ADDRESS: 1 FLEET LANDING BLVD. PROJECT VALUE$$5,000.00
JEA INFORMATION REQUIRED ON ALL PERMITS: 1,000 AMPS 208 VOLTS 3 PHASE
❑ NEW SERVICE: ❑Overhead ElUnderground ❑Underground up Pole
DResidential (Main) Service:
❑0-100 amps 0101-150amps E1151-200amps El-amps #of Meters
❑Commercial(Main) Service:
❑0-100 amps E1101-150amps 11151-200amps •000 amps ❑CT Service amps
Conductor Type xHHw-2 AL Size (3)600/(1)500N
❑Multi-Family(Main)Service:
❑0-100 amps E1101-150amps [1151-200amps [:]_amps #of Unit Meters
TEMPORARY POLE: 200 amps
SERVICE UPGRADE: ❑ amps ❑CT Service amps
❑ NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
❑100 amps ❑150amps ❑200amps ❑ amps [:)CT Service zoo 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
❑ REPAIRS/MISCELLANEOUS:
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG
Wither:For Underground Feeder conduits and Slab Branch conduits only i and temp power pole for construction Updated 10117118
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.
Owner Name: Naval Continuing Care Retirement Foundation Inc. r Ph !ne Number: (904)246-9900
Electrical Company: OWEN ELECTRIC COMPANY,INC. Office Phone (s0alez -ssao Fax:(904)826-1568
Co.Address: 1775 LAKESIDE AVENUE Cit ST. USTI E State: FL. Zip: 32084
License Holder: MICKEY OWEN State C rtific ti /R istration#: EC0000993
Notarized Signature of License Holder LJ )
The foregoing instrument was acknowledged before me his day of 2 )c 'n t Stat u etc,
Signature of Notary Public �v C.0�'�'S10Nmt>et 11'2p2 secs
Z
Personally Known OR[ ] Pro uced Identificatione of Identification:
Register • • ReceiptNumber
AtlanticCity of
DESCRIPTION ACCOUNTQTY PAID
PermitTRAK $250.00
ELPP19-0003 Address: 2395 MAYPORT RD APN: 169398 0150 $62.00
ELECTRICAL $58.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
ELEC SWITCH AND RECEPTACLE OUTLETS 455-0000-322-1000 0 $3.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
ELPP19-0004 Address: 1 FLEET LANDING BLVD 5700 APN: 169397 0200 $94.00
ELECTRICAL $90.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
ELEC REPAIRS AND MISC 455-0000-322-1000 0 $35.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 4S5-0000-208-0600 0 $2.00
TEMP19-0008 Address: 1 FLEET LANDING BLVD 5700 APN: 169397 0200 $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
TOTAL111
Date Paid:Tuesday, February 12, 2019
Paid By: OWEN ELECTRIC CO INC
Cashier: CT
Pay Method: CREDIT CARD 086490
Printed:Tuesday, February 12,2019 4:44 PM 1 of 1 It