1710 BEACH AVE - TEMP20-0004 ,;--:„1..,\,.,,-;-„„,, ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
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4\ TEMP20-0004
. CITY OF ATLANTIC BEACH
r ISSUED: 2/6/2020
800 SEMINOLE ROAD
\;`;.ort1 ATLANTIC BEACH. FL 32233 EXPIRES: 8/4/2020
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:
1710 BEACH AVE ELECTRICAL TEMP POLE TEMP POLE $0.00
TYPE OF iREAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169592 0000 OCEAN GROVE UNIT 01
COMPANY: ADDRESS: CITY: STATE: ZIP:
SCHUMAN ELECTRIC INC. PO BOX 48171 JACKSONVILLE FL 32247
OWNER: ADDRESS: CITY: STATE: ZIP:
GRIFFITH CHRISTOPHER 1710 BEACH AVE 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.
FEES
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: 2/6/2020 1 of 2
(ic.,...J.,./..„ ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
,;. s=- s CITY OF ATLANTIC BEACH TEMP20-0004
;_,.)10... 800 SEMINOLE ROAD ISSUED: 2/6/2020
�°ii9" ATLANTIC BEACH. FL 32233 EXPIRES: 8/4/2020
Issued Date:2/6/2020 2 of 2
Feb. 3. 2920 3: 03PM eau X3-1 � No.*1593. . P. 1.. . .
g, Vii.. Electrical Permit Application ' ALL INFORMATION
i�' -b ,, HIGHLIGHTED.iN
tair
..: City of Atlantic Beach Building Department 'CI{
- 914 GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 � -CrIA P a oc'o4-
Ph +one: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: ?-3- 616
JOB ADDRESS: 1 1.1 0.: ... fir-ji i:::;: f3Ue; ::' • . PROJECT VALUE $ J 660',OD ..
JEA INFORMATION REQUIRED ON ALL PERMITS::AMPS L9,4CQVOLTS I PHASE
E_, NEW SERVICE: ❑Overhead lnderground ❑Underground up Pale
. IZResIdentlal(Main)Service:
❑0-100 amps 10101-150amps .�,hh 1-200amps , u.I_ \ .,nps #of Meters
❑Commercial(Main)Service:
QO-boa amps 0101-150amps 0151-200amps 0 amps OCT Service amps
Conductor Type Size
Multi-Family(Main)Service:
03-100 amps 0101-150amps 1:1151-200amps ❑ amps ff of Unit Meters
TEMPORARY POLE: (p0 amps
El SERVICE UPGRADE: ❑ amps OCT Service amps
❑ NEW FEEDER(ADDITIONS, ACCESSORY STRUCTURES, ETC.):
0100 amps 0150amps 0200amps In amps r T 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
El FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps V`\rG tIE-ul hOo -4, Tv n-k.''
0 REPAIRS/MISCELLANEOUS:
❑Replace Burnt/Damaged Meter Can OSafety Inspection ❑Panel Change DOH to UG
D3ther: a - # Y\ Ilk 5 t . (AYt I Cj 3 110Oi dared 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
Owner Name: pi
)61,r CQlr1��YULliOYl : 4.L
2CC C4+-!j' Phone Number: '. 55:- ql '
Electrical Company: 5(]SIU`yY'�G.Ti• '.1ec)rr1G . Office Phone:'X31 —LINO.,' Fax: 3Qi�-L,1)OLi
Co.Address: • 4 PD 26)C 11 t • ' City:: jay .State::{`.:Zip: Will
License Holder:' _ kih II -1/1 UVYY..YI State Certification/Registration#: E.c, /.O c/Rq
5
Notarized Signature of license Holder, • . • \\ �`
The f, : ::t; • • . • before me this 3iur day of . ' .r Noy, 20 0, in the State of Florida,County of .tom i
HOLLY-WALDEN
IA
. ::
MY COMMISSION#Ooo4AAbnature of Notary Public .4, ~`
r • EXPIRES November 25,202+ dk
�. IV-rsonallyKnown OR l ) Produced Identification
•e of Identification:
to A �, Cash Register Receipt Receipt Number
--)v City of Atlantic Beach R11663
DESCRIPTION I ACCOUNT I QTY I PAID
PermitTRAK $446.00
ERES20-0027 Address: 1710 BEACH AVE APN: 169592 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
ERES20-0030 Address: 630 BEGONIA ST APN: 170921 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
I
TEMP20-0004 Address: 1710 BEACH AVE APN: 169592 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
TEMP20-0005 Address: 630 BEGONIA ST APN: 170921 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: R11663 $446.00
Date Paid: Wednesday, February 05, 2020
Paid By: SCHUMAN ELECTRIC INC.
Cashier: FJ
Pay Method: CREDIT CARD 7
Printed:Wednesday,February 05,2020 4:44 PM 1 of 1 st
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