306 4th St TEMP19-0033 temporary pole permit ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
r s, TEMP19-0033
CITY OF ATLANTIC BEACH
Vr 800 SEMINOLE ROAD ISSUED: 10/29/2019
ATLANTIC BEACH, FL 32233 EXPIRES: 4/26/2020
CODE,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
• AND OF ATLANTIC BEACH OF • +
ALL • • OF PERMIT APPLY, r \ \ 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:
306 4TH ST ELECTRICAL TEMP POLE 100 amps/240 volts/first
phase - temporary pole $250.00
TYPE OFREAL ESTATE BUILDING USE
ZONING: :D •
• • GROUP:
169807 0000 ATLANTIC BEACH
COMPANY: ADDRESS:
MCCLURE ELECTRICAL
CONTRACTORS 1521 Inverness Rd Fernandina Beach FL 32034
ii .
Marshpoint 2300 Marshpoint Rd JACKSONVILLE 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 • . .
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:$94.00
Issued Date: 10/29/2019 1 of 2
ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
TEMP19-0033
CITY OF ATLANTIC BEACH ISSUED: 10/29/2019
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233 EXPIRES: 4/26/2020
Issued Date: 10/29/2019 2 of 2
SQL Electrical Permit Application **ALL INFORMATION
HIGHLIGHTED IN
o• 'rr:
City of Atlantic Beach Building Department GRAY IS REQUIRED.
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800 Seminole Rd, Atlantic Beach, FL 32233 �y
¢`COMM Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: 3 o (. +T14 S k_VL1 t-1- PROJECT VALUE$ Z S a a°
JEA INFORMATION REQUIRED ON ALL PERMITS: 2°'C'AMPS t4r-' VOLTS PHASE
❑ NEW SERVICE: ❑ Overhead ❑Underground ❑Underground up Pole
❑Residential(Main)Service:
1:10-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
❑Commercial (Main)Service:
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
❑Multi-Family(Main)Service:
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
[Z/TEMPORARY POLE: too amps
❑ SERVICE UPGRADE: ❑ amps DCT Service amps
❑ NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
❑100 amps ❑150amps ❑200amps ❑ 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 10/1 /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 give authority to violate the provisions of any other state or local law regulation construction or the performance of
construction. '�Ap
Owner Name: N�0.('s Phone Number:
Electrical Company: Y"\`C.L•- ry e. g\e Jxts c a( Office Phone: 9 o$—Z 3 Z—t-to 1 Fax:
Co.Address: Uy Z.\ L hC SS CA #*,v City: State: i- zip: 37.o 3
License Holder: State ation/Registration#: f~f;000
Notarized Signature of License Holder
The foL ie this day of 2��in the State of Florida,County of
EL�
JENNIFERJOHNSTON
��rCOMMISSION#GG 042884 Signature of Notary Public
�= ;x?iRES:October27,2020•••o?' gondedThruNot, ublicundermiters ersonally Known OR[ ] Produced Identification
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Type of Identification: