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57 Sherry Dr TEMP19-0032 S"''` ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER �� . ,. CITY OF ATLANTIC BEACH TEMP19-0032 ISSUED: 10/15/2019 � 800 SEMINOLE ROAD `.0109" ATLANTIC BEACH. FL 32233 EXPIRES: 4/12/2020 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: I PERMIT TYPE: DESCRIPTION: VALUE OF WORK: 57 SHERRY DR ELECTRICAL TEMP POLE TEMP POLE $100.00 TYPE OF i REAL ESTATE t ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: I NUMBER: GROUP: 169756 0000 ATLANTIC BEACH COMPANY: ADDRESS: CITY: STATE: ZIP: APPLE ELECTRIC, INC 2001 3RD ST NEPTUNE BEACH FL 32266 OWNER: ADDRESS: CITY: STATE: ZIP: AF AB VENTURE LLC 1738 SELVA MARINA DR NEPTUNE BEACH FL 32266 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: 10/15/2019 1 of 2 • ri-�''ri�, ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER ;.., CITY OF ATLANTIC BEACH TEMP19-0032 ISSUED: 10/15/2019 800 SEMINOLE ROAD x0;3 EXPIRES: 4/12/2020 ATLANTIC BEACH. FL 32233 Issued Date: 10/15/2019 2 of 2 Electrical Permit Application **ALL INFORMATION 7-, s v/r� HIGHLIGHTED IN ' City of Atlantic Beach Building Department GRAY IS REQUIRED. 800 Seminole Rd, Atlantic Beach, FL 32233 ' 't City �� - U 0 Z "tr,,t''r Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT it. JOB ADDRESS: -S. 1 _iv\\zf r L-' -0 f PROJECT VALUF '` `0 , P---," IEA INFORMATION REQUIRED ON ALL PERMITS:,I L.)(2- AMPS `f D VOLTS / PHASE L. •JEW SERVICE: 0 Overhead Qt1nderground ❑Underground up Pole ©Residential (Main) Service: 00-100 amps 0101-1S0amps 0151-200amps 0 amps #of Meters ❑Commercial (Main)Service: 00-100 amps 0101-150amps 0151-200amps 0 amps OCT Service amps Conductor Type Size ©Multi-Family(Main) Service: 00-100 amps 0101-150amps 0151-200amps 0 amps #of Unit Meters TEMPORARY POLE: 1 0'- amps ❑ SERVICE UPGRADE: ❑ amps DCT Service amps E NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.): 0100 amps 0150amps 17200amps 0 amps Du Service amps ❑ ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC: Outlets/Switches: 0-30amps 31-100amps 101-200amps Appliances: 0-30amps 31-100am ps 101-200amps A/C Circuits: 0-60amps 61-100amps Heat Circuits: If circuits @ kw Number of Lighting Outlets, Including Fixtures: OTHER ELECTRICAL PROJECTS: ❑Swimming Pool['Sign ❑Smoke Detectors (Qty) ❑Transformers KVA OMotors HP n FIRE ALARM SYSTEM (Requires 3 sets of plans): Qty volts/amps REPAIRS/MISCELLANEOUS: ❑Replace Burnt/Damaged Meter Can ❑Safety Inspection OPanel Change ❑OH to UG Qjther: Updated 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 hav 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 perm perrrl does not,give ayt rity to violate the provisions of any other state or local law regulation construction or the performance 01 construction. '`'d R " 12' 4"�' f e'v S Owner Name: n Phone Number: Electrical Company: /Y'�L ` /tc f' L i.t-C. Office Phone: GUc"-35(1 '9J3 /`) Fax: Co.Address: Z -'u I 3r et 54 City: /0-eel w,sie 3 c I-. State: FL- zip:31-7-4,C License Holder: 6i(a'? 5 1 L,f 5State Certification/Registration tt: 1 K- /3o 3 g 5 Notarized Signature of License Holder -91-cad , The foregoing instrument was acknowledged before me this 15f day of OC-1 , 20 1 C1, in the State of Florida, County of 1l ti r lc JO T . . Signature of Notary Public li c„_L ��� K. C.--Las-4 s. Notary PUb IC State of Florida Beverty Ka [,.ersonally Known OR[ 1 Produced Identification c X My Commission GG 315109 Te of Identification: vt0,A Expires 04/12/2023 Type A. 3 Cash Register Receipt Receipt Number "m City of Atlantic Beach R10739 DESCRIPTION I ACCOUNT QTY PAID PermitTRAK $415.40 ERES19-0302 Address: 55 SHERRY DR APN: 169756 0000 $129.00 ELECTRICAL $125.00 ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00 ELEC NEW SINGLE FAMILY 455-0000-322-1000 200 $70.00 STATE SURCHARGES $4.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 ERES19-0303 Address: 55 SHERRY DR APN: 169756 0000 $129.00 ELECTRICAL $125.00 ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00 ELEC NEW SINGLE FAMILY 455-0000-322-1000 200 $70.00 STATE SURCHARGES $4.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 ERES19-0304 Address: 1460 BEACH AVE APN: 171863 0000 $63.40 ELECTRICAL $59.40 ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00 ELEC LIGHTING OUTLETS,INCLUDING 455-0000-322-1000 4 $2.40 FIXTURES ELEC APPLIANCES FIXED OR STATIONERY 455-0000-322-1000 0 $2.00 STATE SURCHARGES $4.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TEMP19-0032 Address: 55 SHERRY DR APN: 169756 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: R10739 $415.40 Date Paid: Tuesday, October 15, 2019 Paid By: APPLE ELECTRIC, INC Cashier: CT Pay Method: CREDIT CARD 399826 Printed:Tuesday,October 15,2019 12:26 PM 1 of 1i