354 Seminole Rd TEMP19-0025 ''' PERMIT NUMBER
��,,, ELECTRICAL TEMP POLE PERMIT
CITY OF ATLANTIC BEACH
TEMP19-0025
~, 800 SEMINOLE ROAD ISSUED: 8/16/2019
curs»" ATLANTIC BEACH, FL 32233 EXPIRES: 2/12/2020
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL • ' K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' + 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:I
354 SEMINOLE ROAD ELECTRICAL TEMP POLE TEMP POLE $0.00
TYPE OF •
• : • •
i • GROUP:
COMPANY: ADDRESS:
BARKOSKIE ELECTRICAL 953 Shetter Ave JACKSONVILLE FL 32250
SERVICE BEACH
01 ADDRESS: CITY: STATE: ZIP:
MICROBIAL NATURAL 1207 SEMINOLE RD ATLANTIC BEACH FL 32233
PRODUCTS 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 45S-0000-322-1000 0 $3S.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: $94.00
Issued Date 8/16/2019 1 of 2
�S�� CIC�� (�iTG"�C �C��G� 1 176 ':*ALL INFORMATION
r rig, HIGHLIGHTED IN
City of Atlantic Beach I;uMing Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 d Cj ZS
Phone: (904) 247-5826 Email:
, l �PER�MIT#:
JOBADDRESS. 35*
1 � -
s�� l r Joh PROJECT VALUE$ 2 SD
;��11 3EA MFORMATION REQUIRED ON ALL PERMITS: I DO AMPS 7-40 VOLTS ( PRASE
El NEW SERVICE; 0 Overhead El Underground MUnderground up Pole
7.—Residential(Main)Service:
E10-100 amps 0101-150amp5 E1151-200amps amps #of Meters
OCommercial(Main)Service:
[10-100 amps 0101-150amps 0151-200amps ❑ amps OCT Service amps
Conductor Type Size
MMulti-Family(Main)Service:
00-100 amps 0101-150amps X151-200amps ❑ amps #of Unit Meters
TEMPORARY POLE: /D[) amps
SERVICE UPGRADE:❑ amps OCT Service amps
❑
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES, ETC.):
0100 amps 0150amps ❑200amps Fj amps ❑CT 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 @ I<w
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS:
[]Swimming Pool❑Sign ❑Smoke Detectors (Qty) ❑Transformers KVA
❑Motors HP
❑ EIDE ALARM SYSTEM (Requires 3 setts of plans):
Qty volts/amps
❑REPAIRS/MISCELLANEOUS:
❑Replace Burnt/Damaged Meter Can ®Safety Inspection ❑Panel Change []OH to UG
❑Dther. Updated so%v/is
Permit becomes void if work does not commence within a sixmonthperiod 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. Det� 5PLe �-_ 4Z/,
Owner Name: �.� Phone Number: "T"
Electrical Company: 1314 eJ<o5KtC L%LEC?`'Z-1 'L Office Phone: Z' ��73 Fa t;2 9 67
Co.Address: �/3� � �TZ �-t�E City; �'1 ��� State: zip: 32Z 6-2�-)
License Holder; NQS State Certification/Registration#: 3co23 S 7
Notarized Signature of License Holder fi_ ���/� a L
The foregoing instrument was acknowledged before me this 2 da of �uc`y ,20 9 in the Sta of Florida,Count of
Margant A.May
COPIlIIt1iSS 0 6�3 9f0 Signature of Nota Public 1".""K
py
.'`a ires: July 24, 2020 {>]Personally i:nown OR[ ]Produced Identification
a �..�`` Bonded thru Aaron Notary Type of Identification: