369 10th St TEMP20-0003 temporary pole permit rs�vic,.„ ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
, TE M P20-0003
CITY OF ATLANTIC BEACH
)`4 ISSUED: 2/3/2020
800 SEMINOLE ROAD
'1.2.11 - ATLANTIC BEACH. FL 32233 EXPIRES: 8/1/2020
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:
369 10TH ST ELECTRICAL TEMP POLE TEMP POLE $100.00
TYPE OF REAL ESTATE I ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170086 0000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
ALLSTATE ELECTRICAL CTR P 0 BOX 550617 JACKSONVILLE FL 32255
INC.
OWNER: ADDRESS: CITY: STATE: ZIP:
AYERS JOSEPH A & AMY L 369 10TH ST ATLANTIC BEACH FL 32233-5529
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
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: 2/3/2020 1 of 2
0...A4%� ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
�: '� TEMP20-0003
CITY OF ATLANTIC BEACH
,tif, ~� ISSUED: 2/3/2020
800 SEMINOLE ROAD
��a;;»� EXPIRES: 8/1/2020
ATLANTIC BEACH. FL 32233 I
•
Issued Date: 2/3/2020 2 of 2
,
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Electrical Permit Application ALLINFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 1 EI)\.;)ZC. --2C GC;3
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:f 9 0,.3
JOB ADDRESS: 369 10TH STREET PROJECT VALUE$1,100.00
IEA INFORMATION REQUIRED ON ALL PERMITS: __ AMPS 240 VOLTS 1 PHASE
.6W SERVICE: ❑Overhead ❑Underground l nderground up Pole
f
.esidential(Main)Service:
00-100 amps 0101-150amps 0151-200amps Dano amps #of Meters 1
❑Commercial(Main)Service:
❑0-100 amps 0101-150amps 0151-200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service:
❑0-100 amps 0101-150amps 0151-200amps 0 amps #of Unit Meters
1 TEMPORARY POLE: 60 amps 240 \i- 1 phis .c.
I SERVICE UPGRADE: ❑ amps OCT Service amps
NEW FEEDER (ADDITIONS,ACCESSORY STRUCTURES, ETC.):
0100 amps 0150amps D200amps ❑ amps IT Service amps
E ADDITIONS, REMODELS,REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 0-30am ps 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:
DReplace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change DOH to UG
❑Jther: 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 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.
Owner Name: AYERS RESIDENCE Phone Number: 904-947-7792
Electrical Company: ALLSTATE ELECTRICAL CONTRACTORS,INC Office Phone: 904-296-2700 Fax:904-296-3471
Co.Address: 7447 SALISBURY RD City: JACKSONVILLE State: FL Zip: 32256
License Holder: JAMES L. WILLIAMSState Certification/Registration if: EC-000113
Notarized Signature of License Holder947/tese C Le//The foregoing instrument was acknowledged before me this 3Y day of 2 / .,"' 20 in the Stat f Florida,County of 2 u✓Q-/
1stYPua IRIS ANDINO Signature of Notary Public �_
eo Commission#G0305213
# v 1 i w
''m` Expires June 1,2023 [ ersonally Known OR [ I Produced Identification
'40,0„oe� Sondod „MO Wary Swot.)
Type of Identification: