377 7th St TEMP19-0026 temporary pole permit �4
ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
` TEMP19-0026
CITY OF ATLANTIC BEACH
8
ISSUED: 8/22/2019
00 SEMINOLE ROAD
ATLANTIC BEACH. FL 32233 EXPIRES: 2/18/2020
MUST CALL INSPECTION • ! • 1 , 247-5814 BY , PM FORDAY i
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • ' ! BUILDING
CODE, AND CITY OF • ! 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: PERMITTYPE: DESCRIPTION: VALUE OF WORK:
377 7TH ST ELECTRICAL TEMP POLE TEMP POLE $200.00
TYPE OFREALESTATE
ZONING: : ! •
• • GROUP:
169944 0000 SHERRY TERRACE R/P
COMPANY: ADDRESS:
MUNSON & BRYAN
ELECTRICAL CO. 3434 ST AUGUSTINE RD JACKSONVILLE FL 32207
• A! ! • STATE:
Jeff Newman 377 7TH ST ATLANTIC BEACH FL 32233-5433
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.
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: 8/22/2019 1 of 2
ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH TEMP19-0026
r? 800 SEMINOLE ROAD ISSUED: 8/22/2019
ATLANTIC BEACH, FL 32233 EXPIRES: 2/18/2020
Issued Date:8/22/2019 2 of 2
Electrical Permit Application �`HIGHLIGHTEDIN
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
hJ 800 Seminole Rd Atlantic Beach FL 32233 ��
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: 377 7th street PROJECT VALUE$$ 2&b: a
JEA INFORMATION REQUIRED ON ALL PERMITS: AMPS 240 VOLTS 1 i PHASE
❑NEW SERVICE: [3 Overhead ❑Underground ElUnderground up Pole
oResidential(Main)Service:
❑0-100 amps [1101-150amps [3151-200amps ❑ amps #of Meters 1
❑Commercial(Main)Service:
❑0-100 amps [3101-150amps 11151-200amps ❑ amps []CT Service amps
Conductor Type Size
Multi-Family(Main)Service:
[3D-100 amps 0101-150amps [1151-200amps []_amps #of Unit Meters
TEMPORARY POLE: 40 amps
SERVICE UPGRADE: ❑ amps OCT Service amps
❑ NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES, ETC.):
0100amps ❑150amps 0200amps []_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 @ 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 updated 10/17/18
D)ther:
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: Newman Y ror-�•�.r,� - —_..,_ ._ j''Phone Number: 04)838-121
Fax:
Munson And"an Electric Office Phone: t�4i�w+�
Electrical Company: _
.. - ,..
q rPL .,
Co.Address: 3434 St Augustine Rd city: Jax State Zip. 32207
_....,
, E6-0001795,
License Holder:;6hn SGIOIInO State Certification/Registration#:.
Notarized Signature of License Holder x
The foregoing instrument was acknowledged before me this day of 0 , in th tat of Florida,County of
Dennard Sign ure of Notary Public,Tammy
NOTARY PUBLICSTATE OF FLORIDA Personally Known OR[ ]Produced Identification
Comm#GG168521 Type of Identification:
ExPires 12/14/2021
LaiCash Register Receipt Receipt Number
ofAtlantic Beach • • • '
DESCRIPTION ACCOUNTQTY PAID
PermitTRAK $243.18
ERES19-0246 Address: 377 7TH ST APN: 169944 0000 $149.18
ELECTRICAL $145.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
ELEC NEW SINGLE FAMILY 455-0000-322-1000 300 $90.00
STATE SURCHARGES $4.18
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.18
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TEMP19-0026 Address: 377 7TH ST APN: 169944 0000 $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
TOTAL FEES PAID BY RECEIPT: R9907 $243.18
Date Paid: Thursday, August 22, 2019
Paid By: MUNSON & BRYAN ELECTRICAL CO.
Cashier: CT
Pay Method: CREDIT CARD 29332G
Printed:Thursday,August 22,2019 9:17 AM 1 of 1 �'