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610 Begonia St TEMP19-0021 ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER CITY OF ATLANTIC BEACH TEMP19-0021 800 SEMINOLE ROAD ISSUED: 6/6/2019 ATLANTIC BEACH. FL 32233 EXPIRES: 12/3/2019 MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION. ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • ' CODE, ' OF • OF • ' 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: 610 BEGONIA STREET ELECTRICAL TEMP POLE TEMP POLE $1000.00 TYPE OF • • GROUP: 1709210000 ATLANTIC BEACH SEC H .DD. STATE: SCHUMAN ELECTRIC INC. PO BOX 48171 JACKSONVILLE FL 32247 • ADDRESS: HOLSTAR LLC 6685 BOWIE RD JACKSONVILLE Fl- 32219 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. 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: $94.00 Issued Date:6/6/2019 1 of 2 Jun. 4. 2019 4: 44PM No. 1089 P. 2 Electrical Permit Application '"ALL INFORMATION r HIGHLIGHTED IN City of Atlantic Beach Building Department GRAY IS REQUIRED. s: 800 Seminole Rd, Atlantic Beach, FL 32233 C_� C 2- F'f ' Phone: (904) 2475826 Email: Building-Dept@coab.us PERMIT l �CJOB ADDRESS: �('. �1'IiG ��-t-- • PROJECTVALUE$,- (� — 1 JEA INFORMATION REQUIRED ON ALL PERMITS:j _ v _%MPS T VOLTS_ PHASE NEW SERVICE: 0 Overhead Underground ®Underground up Pole iffiResidential(Main)Service: ®0-100 amps 0101-150amps 151-200amp5 �_T _ amps #of Meters �. ®Commercial (Main)Service: ©O-100 amps ©101-150amp5 0151-200amps Q amps ®CT Service amps Conductor Type Size ©Multi-Family(Main)Service: Q ®0-100 amps 0101-150amps 0151-200amps 0—amps #of Unit Meters TEMPORARY POLE: amps M SERVICE UPGRADE:❑ amps ❑CT Service amps ❑ NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.): J100 amps ®150amps ©200amps __,amps M7Service amps ❑ ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES-ETC: Outlets/5wltche5: 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: [7Swirnming Pool❑Sign C1Smoke 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 QOH to UG at h e r: updooed 10/17/18 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 carred. All provisions of laws and ordinances goveming 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. f� Owner Name: w r J.'Z ortie�7N rlrrTber: J r�� Electrical Company, � tL. Office Phone: 13. 1 'U U Fax: �—l6- q IGLj Co.Address: C L city: , � G k State:�zip: 2� License Holder; ) state Certification/Registration#: Notarized Signature of License Holder The foregoing instrument was acknowledged efore a this Qf2iay of 20 in the State of Florida,County of \I�, HOLIIf WALDEN sl ure oflNotary Public OM MY COMMISSIONESNovember X Gr-0444 5,.20 EXPIRES Novernser 26.20 rsonally Known OR[ ]Produced Identification R07 of Identification: