1186 Stocks St TEMP19-0028 rS'�Lrt ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
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j,�`'.; CITY OF ATLANTIC BEACH TEMP19-0028
v~ 800 SEMINOLE ROAD ISSUED: 9/24/2019
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`0.711 r 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:
1186 Stocks St. ELECTRICAL TEMP POLE 60 amps/240 volts/first $150.00
phase -temporary pole
TYPE OF 1 REAL ESTATE BUILDING USE
ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
COMPANY: I 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 ATLANTIC 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
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 /�
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: Tvpi -1 Q
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JOB ADDRESS: //J.-76 O 'e : 5-t PROJECT VALUE $ (9) `.)6
�lX/JEA INFORMATION REQUIRED ON ALL PERMITS: AMPS VOLTS / PHASE
NEW SERVICE: ❑ Overhead ❑Underground ❑Underground up Pole
,Residential (Main) Service:
❑0-100 amps r 1101-150amps o151-200amps ❑ amps #of Meters
iiCommercial (Main)Service:
❑0-100 amps o101-150amps D151-200amps ❑ amps DCT Service amps
Conductor Type Size
Multi-Family(Main)Service:
❑O-100 amps o101-150amps n151-200amps ❑ amps #of Unit Meters
TEMPORARY POLE: t -.amps
SERVICE UPGRADE: ❑ amps I ,CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
100 amps 150amps - 200amps I_ amps DCT Service amps
Li ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS, ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 0-30a m Ps 31-100amps 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:
H1 OTHER ELECTRICAL PROJECTS:
Swimming Pool riSign ❑Smoke Detectors (Qty) ❑Transformers KVA ❑Motors HP
Li FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
[--1 REPAIRS/MISCELLANEOUS:
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change DOH to UG Updated l0/17/18
❑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 permit does not ive authority t violate th rovisions of any other state or local law regulation construction or the performance of
construction. 'l ��/ //....�`OwnerName: /".5,
! L i C authority
'� Phone Number:
Electrical Company: 71 /�1/ 1 _-/ - Office Phone: lX / O Fax:
Co.Address: /./(;,' ( ij� l 'c i City: `\ 'L `
State:: / Zip:31:,-2-e.License Holder: ea �44.-/r-.11,7 State Certification/Registration#: iEt /
Notarized Signature of License Holder i/; / � ,,-
The foregoing instrument was acknowledged before me this a� day of—% 20 VI,in the State of Florida, County ofvti.]
,0;'"; JENNIFER JOHNSTON , Signature of Notary Public �..
, •'*' c� MY COMMISSION#GG 042984
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•;1":1,:;,...4,1::%•o EXPIRES:October 27,2020 [ ] Personally Known OR [�,Pfodu -d Identificati.n ,
'-:;;;„ Bonded Thru Notary Public Underwriters ' Type of Identification: il0 k d ' ' I J -__