630 BEGONIA ST - TEMP20-0005 ,;s''U'tJ y ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
41110..
��.; a ' CITY OF ATLANTIC BEACH TEMP20-0005
''rISSUED: 2/6/2020
_ 800 SEMINOLE ROAD
"T�'i�� " 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:
630 BEGONIA ST ELECTRICAL TEMP POLE TEMP POLE $200.00
TYPE OF I REAL ESTATEZONING: { BUILDING USE
CONSTRUCTION: NUMBER: GROUP: SUBDIVISION:
170921 0000 ATLANTIC BEACH SEC H
COMPANY: ADDRESS: CITY: STATE: ZIP:
SCHUMAN ELECTRIC INC. PO BOX 48171 JACKSONVILLE FL 32247
OWNER: ADDRESS: CITY: STATE: ZIP:
HOLSTAR LLC 6685 BOWIE RD JACKSONVILLE FL 32219
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: $94.00
Issued Date: 2/6/2020 1 of 2
ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH TEM
P20-0005
i 800 SEMINOLE ROAD
ISSUED: 2/6/2020
"(,f--- ,
' ' ATLANTIC BEACH. FL 32233 EXPIRES: 8/4/2020
Issued Date:2/6/2020 2 of 2
'`Syw„' Electrical Permit Application **ALL INFORMATION '
HIGHLIGHTED IN
t City of Atlantic Beach Building Department GRAYISREQUIRED,
800 Seminole Rd, Atlantic Beach, FL 32233 _ 1 E4-\\PZU -0005
"�11.'` Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: aES ICI - 0a1S`
JOB ADDRESS: 'AO Rent)n iGi circ A- PROJECT VALUE$ . O0-0 Cr
JEA INFORMATION REQUIRED ON ALL PERMITS: (D CAMPS '?%VOLTS l PHASE
NEW SERVICE: 0 Overhead Underground ❑Underground up Pole
I tesidential(Main)Service:
❑0-100 amps ❑101-150amps : 1-200amps mps #of Meters_ —
❑Commercial(Main)Service:
00-100 amps 0101-150amps 0151-200amps ❑ amps OCT Service amps
Conductor Type Size
®Multi-Family(Main)Service:
00-100 amps ❑1011--1150amps 0151-200amps El amps #of Unit Meters
itTEMPORARY POLE: 6 V amps
❑SERVICE UPGRADE: ❑ amps OCT Service amps
❑ NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
0100 amps ❑150amps Q200amps 0 amps OCT Service amps
❑ ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 0-30a mps 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
n REPAIRS/MISCELLANEOUS:
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ['Panel Change 00H to UG
[Other: 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. 1
Owner Name: 6Te..... 3TL1r k(? Phone Number: 7 37"'1-1Uy0
Electrical Company: cichu(YY-An^� E 1 CC.+�"1'i C, Office Phone: ---7::)-1'.7 140(-10 Fax: 3e)L,•.LI1Qy
Co.Address: f O 138 Y LIS i 1 I City: J COe State: FL-Zip: ,-;22.4 7
License Holder: JO n -hLsima•t') State Certification/Registration#: Ec )Aoncv (1�
Notarized Signature of License Holder "''t.r� 3
The fo ege' before is iay of r`-hwG,e9 20 in the State of Florida, County of Dv iUcA 1
+off c d; HOLLY- AL t `
. L.,,' •"�MY COMMISSION#GGO4448fgnature of Notary Public
-'�- EXPIRES November 25,202
f ersonally Known OR [ ] Produced Identification
Type of Identification:
I