1939 Francis Ave TEMP20-0030 `J./7j ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
t' TEMP20-0030
' CITY OF ATLANTIC BEACH
,v_ 1~ 800 SEMINOLE ROAD ISSUED: 11/19/2020
.--L2211.1_.r ATLANTIC BEACH. FL 32233 EXPIRES: 5/18/2021
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:
100 amps/240 volts/first
1939 FRANCIS AVE ELECTRICAL TEMP POLE phase -temp pole for new $100.00
home
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172102 0000 DONNERS S/D PT LOT 2
17-
COMPANY: ADDRESS: CITY: STATE: ZIP:
AIR CONDITIONING & 2719 Holly Point Rd ORANGE PARK FL 32073
HEATING 911 dba AC911
OWNER: ADDRESS: I CITY: I STATE: ZIP:
AB VENTURE LLC 1738 SELVA MARINA DRIVE ATLANTIC BEACH FL 32233-4229
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT If\
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.
.. ....
rg 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
I
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
Issued Date: 11/19/2020 1 of 2
,,:cIA`' ELECTRICAL TEMP POLE PERMIT PERMIT NUMBER
r t'Pr
TEMP20-0030
Jv r CITY OF ATLANTIC BEACH ISSUED: 11/19/2020
800 SEMINOLE ROAD
`-.4O';!;) ATLANTIC BEACH. FL 32233 EXPIRES: 5/18/2021
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$94.00
Issued Date: 11/19/2020 2 of 2
Electrical Permit Application, **ALL INFORMATION
rr HIGHLIGHTED IN
_ ; City of Atlantic Beach Building Department GRA,...S REQUIRED
/ ' 800 Seminole Rd, Atlantic Beach, FL 32233 ,be-' I oo
�3
j Phone: (904) 247-5826 Email: uudng-Deptcoab.us PERMIT#:
�f5 20 -00/
JOB ADDRESS: )Q 3' r ll-A)ars 3-1— PROJECT VALUE$ /DG, o 3
JEA INFORMATION REQUIRED ON ALL PERMITS: 40 J AMPSc2 -)VOLTS t PHASE
nNEW SERVICE: 0 Overhead ❑Underground ['Underground up Pole
EResidential (Main)Service:
00-100 amps D101-150amps 0151-200amps ❑ amps #of Meters
❑Commercial (Main)Service:
00-100 amps 0101-150amps 0151-200amps 0 amps OCT Service amps
Conductor Type Size
DMulti-Family(Main)Service:
00-100 amps 0101-150amps 0151-200amps 0 amps #of Unit Meters
EMPORARY POLE:/0° amps
❑ SERVICE UPGRADE: ❑ amps OCT Service amps
n NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
0100 amps 0150amps 0200amps 0 amps OCT Service amps
❑ ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS, ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 0-30am ps 31-100amps 101-200am ps
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 OMotors 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
Dither:
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: �Q�� �I^), � Phone Number:1q
Electrical Company: A/c e it X44 .f 9 ,r i I I LI C Office Phone: 9u'- 339 • /37$ rFax:
Co.Address: 3-1
,GI: I-�c� 1� - P(? 1*� % City:0C-A-1-)-6E State: ( L zip:3 20 7 3
License Holder: -3 c)x AL4O .t .% , 9 State Certification/Registration#: tom'C 1300 (p3 5 g
Notarized Signature of License Hold'
The foregoing instrument was acknled before me this' ay of /1/4-(`)J ,2020 in the State of Florida,County of'but OA-4-
"" Nora P„p Signature of Notary Public 13e.ANA.AS .1.< E,,,P......A.004.
'en
Nc Staff or Fda
• 8everiy K E►ias
I, %aw/ MyEComm 315108 4 [ Personally Known OR [ ] Produced Identification
: A Type of Identification:
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