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230 10TH ST ELECT TEMP POLE PERM ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER CITY OF ATLANTIC BEACH TEMP19-0009 800 SEMINOLE ROAD ISSUED: 3/1/2019 ATLANTIC BEACH. FL 32233 EXPIRES: 8/28/2019 MUST CALL INSPECTION • i • 1 + 247-5814 BY + PM FOR • • ALL i ' K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' D+ 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: 230 10TH ST ELECTRICAL TEMP POLE 60 amps/240 volts/single- $100.00 phase -temporary pole TYPE OF • • GROUP: 170357 0000 ATLANTIC BEACH PARKWAY COMPANY: ADDRESS: ' TRI COUNTY ELECTRICAL 11637 E COLUMBIA PRK DR JACKSONVILLE FL 32258 • ADDRESS: FRANCIS JAMES D 230 10TH ST ATLANTIC BEACH FL 32233-5750 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. i 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: 3/1/2019 1 of 2 02/24/2019 14:54 9042609688 TRICOUNTY PAGE 01/02 Permit fico 1. EElectricalA pip than � } , }` Beach Building Department ', =.f.,> .; f�y, 1?il >ai .' City of Atlantic `Oct)c� 300 Seminole Rd, Atlantic Beach, R 322333 � CQBb_,.US PERMIT �-- - " Phone Email:9�4 2,47-6. .'•�.,: d �..--- LU ( } 826 II: Bui �r� PROJECT VA $ .,. JOBS ADDRESS' JEA INFORMATION REQUIRED ON ALL PERMITS: ,.eY '�AMPSc VOLTS_ -'`PHASE "`� NESERVICE: M Overhead 1nderground ©Underground up Pole "Residential (Main)Service: amps #of Meters �10-100 amps ®101-150amps ;i X51-200amps ILS___. [icortimerclal (Main)Service: ❑1151.200am s � amps ECT Service amps r_70.100 amps 0101-150amps P Conductor Type Size MMulti-Family(Main)Service: amps #of I,JnIt Meters C30-100 amps 0101-150amps X151-200ampsI — TEMPORARY POLE: 0 ,.amps SERVICE UPGRADE: 0—amps OCT Service—amps p NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC,): ©10(,)amps E]150amps E22008mps 0—amps aT Service amps ADDItIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC: 0-30amps 31.100amps X101-200amps outlets/Switches: � Appliances: 0-30amps _31.100amps —1.01-200amps A/C Circuits: 0-608mps _61-100amps Heat Circuits: # circuits @—kw N'uMber of Lighting Outlets, Including Fixtures: OTHt.R ELECTRICAL PROJECTS: KVA [Motors_HP ❑Swimming Pool QSign ❑/Smoke Detectors (Qty) [�T ransformers FIRE ,'ALARM SYSTEM (Requires 3 sets of plans), Qty volts/amps ° REPAIRS/MISCELLANEOUS: ❑{Replace Burnt/Damaged Meter Can 05afety Inspection ©Panel Change [30H to U15 Updated 10/17/13 [ptlher: Permit becomes void if work does not commence within a six month period or•work Is suspended or abandoned for ilx 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 governlnq this work will be compiled 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, :i>i,iy':;i;i°'t' "'i;;` ;'4''''i*JiFrl3 %':Phone Number; .a Owner Namy1 ?: .. ::. ..: `% (,;� ;y �"" ?';'rJitiOfflce Phoney Electrical Company; " r•. ;',rr,; :..: city.:, '>tate: Zip; co,Address ' ,:: .rs;„ ..�'.:•:r: � ,� >.. '; ';:� `• :iY? <I: '. h; ;,5;;' tat c ification/Reqs - -- Stat ration# �..r'.':,.1. : s License HQ1den, �.,,. •t t.; :<..};::;;ij'1,;.4,+f;,:S;t;;?';•,'rrY�")(iyr^;1,r3;,:,,:,'" I"I'll' :. 1.ly:;;"n.,,,yy�: ••`:h'' i.' ',:_' s.: ;C',:`.: I', .;i• ., ..'ii. ':. >, :I. I ;lily.,,..:., ......,� .:I,t..:. ''.�. ,,, , Notarized Signature of License Holder;,.: ' " ? f1 u "e s cic_"wledged be ` `�fore me this day of rf �ol�- In the State of Florida, County of aw. s� TAMMY PALL Signature of Notary Public *t+'{ Notary Public-State of Florlda •. + a (,ommisslon#FF 995425Personally Known OR ]Produced Identification My comm,Expiros Jul 6,202(1 ' Ty e of Identification. Bbged through National Notary Assn. sh Register Receipt Receipt Number • City ofAtlanticBeach • 299 DESCIRIPTION ACCOUNTQTY PAID PermitTRAK $94.00 TEMP19-0009 Address: 230 10Th ST APN: 170357 0000 $94.00 ELECTRICAL $90.00 ELEC TEMP SERVICE 455-0000-322-1000 $35.00 ELECTRICAL BASE FEE 455-0000-322-1000 $55.00 STATE SURCHARGES $4.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 1 0 $2.00 iTOTAL FEES PAID BY RECEIPT: R8299 $94.00 Date Paid: Friday, March 01, 2019 Paid By: TRI COUNTY ELECTRICAL Cashier: CT Pay Method: CREDIT CARD 011022 Printed: Friday,March 01,2019 11:22 AM 1 of 1 miunr