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1711 Beach Ave TEMP19-0011 temporary pole permit ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER CITY OF ATLANTIC BEACH TEMP19-0011 ISSUED: 3/11/2019 800 SEMINOLE ROAD EXPIRES: 9/7/2019 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. DESCRIPTION: JOBAD-DRESS: PERMITTYPE: VALUE OF WORK: Em 1711 BEACH AVE ELECTRICAL TEMP POLE 60 amps/240 volts/single- $200.00 phase -temporary pole TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 1696610000 NORTH ATLANTIC BCH UNIT 1 COMPANY: I ADDRESS: CITY: S E: UNITED ELECTRIC COMPANY OF 5716 SAINT AUGUSTINE ROAD JACKSONVILLE FL 32207 JACKSONVILLE CITY: OWNER: ADDRESS: STATE: PECORARO RUSSELL 1211 SALT MARSH LN FLEMING ISLAND FL 32003 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. FEES 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 Issued Date:3/11/2019 1 of 2 ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER TEMP19-0011 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ISSUED: 3/11/2019 ATLANTIC BEACH, FL 32233 EXPIRES: 9/7/2019 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL:$94.00 Issued Date: 3/11/2019 2 of 2 Electrical Permit Application "ALL INFORMATION HIGHLIGHTED IN r) City of Atlantic Beach Building Department GRAY IS R�.QLIIRED. 1 800 Seminole Rd, Atlantic Beach, FL 32233 -T&tk'p I q 0 0 1 Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: RES-1 ? -0 JOB ADDRESS:- 1 -111 6 0-0' 01 k R V-e- IN)I -PROJECT VALUE$ 7- 0!9- 0 0 JEA INFORMATION REQUIRED ON ALL PERMITS: 6 0 AMPS )V 0 VOLTS PHASE El NEW SERVICE: 0 Overhead 0Underground []Underground up Pole E3Residential(Main)Service: 00-100 amps [3101-150amps 0151-200amps EL-amps #of Meters OCommercial(Main)Service: [10-100 amps 0101-150amps 11151-200amps El amps [3CT Service_amps Conductor Type Size []Multi-Family(Main)Service: OD-100 amps 0101-150amps [1151-200amps [3_amps #of Unit Meters TE'MPORARY POLE: 60 amps o 4 OSERVICE UPGRADE:[]_amps OCT Service amps NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES, ETC.): C]100 amps [3150amps []200amps 0 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 05ign []Smoke Detectors (Qty) ElTransformers KVA []Motors HP F�FIRE ALARM SYSTEM (Requires 3 sets of plans): Qty volts/amps REPAIRS/MISCELLANEOUS: E]Replace Burrvt/Damaged Meter Can []Safety Inspection OPanel Change E]OH to UG ather: Updated 10/17118 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: s e- C o r a c o Phone Number: Y6 3 - L/4 ob -73 1 - / 2'/'�' --73/ - 53 Electrical Company: UAI+tJ 016�r,-4- CO OP J�4 OfficePhone: L Fax:- Co.Address: 5-7/ G, 5 vc, L) 6 City: J-C.>& State:FL- _zip: 3.2-2 !0'7 License Holder: W W " (,k r-'t A 1h 161014 State Certification/Registration#: 125C 13 0 0 53 6 7 Notarized Signature of License Holder.. The foregoing instrument was acknowledged belore me this 1LLr%y of fharck Signature of Notary Public. in�tSta e I Florida,County of A) �&'Ay "N, BRENDA K. GRIFFIN 44fe'rsonally Known OR[ I Produced Identification MY COMMISSION#GG 193986 Type of Identification: EXPIRES April 23,2022 OF Fl.