1102 Stocks St TEMP19-0029 i Jsi �\ ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH
TEMP19-0029
Jv, / 800 SEMINOLE ROAD ISSUED: 9/24/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 3/22/2020
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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1102 Stocks St. ELECTRICAL TEMP POLE 60 amps/240 volts/first $150.00
phase - temporary pole
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
COMPANY: ! ADDRESS: CITY: STATE: ZIP:
ELITE ELECTRICAL 11611 CAPE HORN AVE JACKSONVILLE FL 32246
SERVICES LLC
OWNER: ADDRESS: CITY: STATE: ZIP:
ASM Riverside Holdings 2000 Florida Blvd Neptune Beach FL 32233
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: 9/24/2019 1 of 2
Electrical Permit Application **ALL INFORMATION
pr HIGHLIGHTED IN
f--- City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 Q
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: -Temr Kt - ,
JOB ADDRESS: /("6 ' ����/ 5---7"- PROJECT VALUE $ L� - 6t)
7/4. ,
JEA INFORMATION REQUIRED ON ALL PERMITS: AMPS VOLTS ( PHASE
NEW SERVICE: Overhead ❑Underground ❑Underground up Pole
Residential (Main) Service:
❑0-100 amps 101-150amps n151-200amps ❑ amps #of Meters
❑Commercial (Main)Service:
❑0-100 amps u101-150amps o151-200amps ❑ amps ECT Service amps
Conductor Type Size
nMulti-Family(Main)Service:
n0-100 amps o101-150amps E151-200amps ❑ amps #of Unit Meters
Cl TEMPORARY POLE: X amps
Li SERVICE UPGRADE: n amps nCT Service amps
LJ NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
100 amps L 150amps 200amps amps ECT Service amps
ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS, ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 0-30amps 31-100a mps 101-200a mps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
LL OTHER ELECTRICAL PROJECTS:
uSwimming Pool ❑Sign I[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
❑Other:
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 per it do not give authority to v'olate theroo isi ns oc ny other state or local law regulation construction or the performance of
construction. �j / i / /a/
Owner Name: Phone t / ��� Phone Number:
Electrical Company: _1/ er /'GR( 4ffice Phone: 9v[ 12/ & Fax:jr� Jy
Co.Address: //i /( ( ! v 4 r' City: State: i L Zip: 31 4'
e �LJ' �/ 0 Y I
License Holder: 2� �!"/ �✓ State Certification/Registration#: � �
Notarized Signature of License Holder A"
TI- • -••• _ __.._.._- --• -.' ledged before me this a' day of -M 20 t in the State of Florida,County of fl cto t i
,.PF.,iy ., JENNIFER JOHNSTON (,(
?+q..as MY COMMISSION#GG 042984 Signature of Notary Public RY.\----K-2`l\J
i t �^' �`= EXPIRES:October 27,2020
''� ' [ J Personally Known OR [ ro uced Identification
, e; Notary Public Underwriters
•.Fo ... Bonded < <: S
Type of Identification: 1 i.4 4-,1 ( rl