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1753 E PARK TER - TEMP20-0008 `1.-Ai ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER r.a_. CITY OF ATLANTIC BEACH TEMP20-0008 'r ISSUED: 3/11/2020 800 SEMINOLE ROAD �"ortI/v ATLANTIC BEACH. FL 32233 EXPIRES: 9/7/2020 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: 1753 E PARK TER ELECTRICAL TEMP POLE TEMP POLE $50.00 TYPE OF 1 REAL ESTATE i BUILDING USE ZONING: SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 172020 0410 SELVA MARINA UNIT 08 COMPANY: ADDRESS: CITY: STATE: I ZIP: INTEGRITY FIRST ELECTRIC JACKSONVILLE 920 8TH AVENUE S#D FL 32250 COMPANY BEACH OWNER: ADDRESS: CITY: I STATE: E ZIP: PETERSON ALIZA 520 MORNING SIDE DR PONTE VEDRA FL 32233 BEACH 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. 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: 3/11/2020 1 of 2 cy'',. ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER CITY OF ATLANTIC BEACH TEMP20-0008 ISSUED: 3/11/2020 800 SEMINOLE ROAD< <rEXPIRES: 9 7 2020 ��';�� ATLANTIC BEACH. FL 32233 Issued Date:3/11/2020 2 of 2 Electrical Permit Application "ALL INFORMATION "'-- �� HIGHLIGHTED IN .:iA0::– '' City of Atlantic Beach Building Department GRAY IS REQUIRED. ( 800 Seminole Rd, Atlantic Beach, FL 32233 E--r("\PZCj_000 8 Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: JOB ADDRESS: 1753 Park Terrace East Atlantic Beach PROJECT VALUE $$ 50.00 JEA INFORMATION REQUIRED ON ALL PERMITS: 200 AMPS 240 VOLTS 1 PHASE nNEW SERVICE: 0 Overhead DUnderground ❑Underground up Pole $Residential (Main) Service: 00-100 amps D101-150amps 0151-200amps El amps # of Meters ['Commercial (Main) Service: 00-100 amps 0101-150amps 0151-200amps 0 amps OCT Service amps Conductor Type Size y DMulti-Family (Main) Service: ❑3-100 amps 0101-150amps 0151-200amps 0 amps #of Unit Meters IT TEMPORARY POLE: 60 amps CI SERVICE UPGRADE: 0 amps OCT Service amps NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.): 0100 amps 0150amps ❑200amps 0 amps 03T Service amps ❑ 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: ['Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change DOH to UG :Other: updated l0/17/18 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: Walter Haynes / P 1 t yzck Pe` z rs 0 eN Phone Number: (904)246-6613 Electrical Company: Integrity First Electric Company Office Phone: (904)246-6613 Fax: Co. Address: 920D 8th Ave. S. City: Jacksonville Beach State: FL Zip; 32250 License Holder: Walter Haynes State Certification/Registration#: EC13003883 Notarized Signature of License Holder IV) — Th: • -!•.•:. .- •- •-d before me t is g/)"---day ofii)/}gCl F-1- , 20�t in the State of Florida, County of/(,C'04(._- SUZANNE THOMPSON , ) - _'�.'� ':. .ignature of Notary Publ`" L-L''Leo_�.-( cl\C�1L',S$) �% ••:Commission I GG 204797 �� L.) • r.. -:,..y�.;d? Expires April 8,2022 f.i ft Bonded TlruTroy Fain Insurance 100-185-7019 ersonally Known OR ( I Produced Identification ype of Identification: