1240 Seminole Rd TEMP20-0002 Temp , ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
g CITY OF ATLANTIC BEACH TEMP20-0002
j7110V, SEMINOLE ROAD ISSUED: 1/15/2020
��s:3>� ATLANTIC BEACH. FL 32233 EXPIRES: 7/13/2020
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:
1240 SEMINOLE RD ELECTRICAL TEMP POLE TEMP POLE $2800.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171937 0005 SELVA MARINA UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
TRI COUNTY ELECTRICAL 11637 E COLUMBIA PRK DR JACKSONVILLE FL 32258
OWNER: ADDRESS: CITY: STATE: ZIP:
NEIDHOLD SCOTT T 1627 BRICKELL AVE #2804 MIAMI FL 33129
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.
..f�S
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: 1/15/2020 1 of 2
;11.-LPrk ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH Li z TEMP20-0002
800 SEMINOLE ROAD ISSUED: 1/15/2020
"�ji��`� ATLANTIC BEACH. FL 32233 EXPIRES: 7/13/2020
Issued Date: 1/15/2020 2 of 2
Electrical Permit Application
"ALL INFORMATION
r�,'r .�`:�, pp HIGHLIGHTED IN
ftb.s�" City of Atlantic Beach Building Department GRAY IS REQUIRED.
Ing
800 Seminole Rd, Atlantic Beach, FL 32233 ��IfY\P 20' 0001-
T- Phone:'(904) 247-5826 Email: Bu (ding-Dept@coab.us PERMIT#: / 1— G/vc--_
JOB ADDRESS: 1 L(0 5C, m , .14.. Ve (',..,• (k__,f PROJECT VALUE $ •.)-SLr� G i
JEA INFORMATION REQUIRED ON ALL PERMITS: 5( AMPS -5L VOLTS PHASE
El NEW SERVICE: ❑Overhead ❑Underground ❑Underground up Pole
❑Residential (Main)Service:
00-100 amps 0101-150amps 0151-2C Oamps 0 amps #of Meters
OCommercial(Main) Service:
00-100 amps 0101-150amps 0151-2C Clamps ❑ amps OCT Service amps
Conductor Type Size
• ❑Multi-Family(Main)Service:
03-100 amps 0101-150amps ❑151-2C Oamps ❑ amps #of Unit Meters
TEMPORARY POLE: - amps C.;\'' '- -- 5( `7— 0 (9o )
El SERVICE UPGRADE: 0 amps [ICT Service amps
E NEW FEEDER (ADDITIONS, ACCESSORY STRUCTUItES, ETC.):
0100 amps 0150amps D200amps 0 :imps OCT Service amps
._ ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,<,CCESSORY STRUCTURES, ETC:
Outlets/Switches: 0-30amps 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: _
n 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_
n REPAIRS/MISCELLANEOUS:
❑Replace Burnt/Damaged Meter Can ElSafety Inspection [Panel Change DOH to UG
❑Jther: updated 10/17/18
ININt
Permit becomes void if work does not commence within a six month perit d 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 wikjticNie4 not give authority to yjglate)1#?revisit ns of any other state or local law regulation construction or the performance of
•construction. p, ;
ts1
-_ Cash Register Receipt Receipt Number
City of Atlantic Beach R11479
DESCRIPTION I ACCOUNT I QTY PAID
PermitTRAK $94.00
TEMP20-0002 Address: 1240 SEMINOLE RD APN: 171937 0005 $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: R11479 $94.00
Date Paid: Wednesday,January 15, 2020
Paid By:TRI COUNTY ELECTRICAL
Cashier: LE
Pay Method: CREDIT CARD 4
Printed:Wednesday,January 15,2020 2:23 PM 1 of 1