723 Sherry Dr TEMP21-0016 Temp PoleOWNER:ADDRESS:CITY:STATE:ZIP:
RIVERSIDE HOMES OF N FL 414 OLD HARD RD STE 502 ORANGE PARK FL 32003
COMPANY:ADDRESS:CITY:STATE:ZIP:
TRI COUNTY ELECTRICAL 11637 E COLUMBIA PRK DR JACKSONVILLE FL 32258
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169946 0000 SHERRY TERRACE R/P
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
723 SHERRY DR ELECTRICAL TEMP POLE Temp Pole: 60 Amps $150.00
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
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
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.
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.
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.
1 of 2Issued Date: 5/10/2021
PERMIT NUMBER
TEMP21-0016
ISSUED: 5/10/2021
EXPIRES: 11/6/2021
ELECTRICAL TEMP POLE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 5/10/2021
PERMIT NUMBER
TEMP21-0016
ISSUED: 5/10/2021
EXPIRES: 11/6/2021
ELECTRICAL TEMP POLE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $94.00
TEMP21-0016 Address: 723 SHERRY DR APN: 169946 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: R15757 $94.00
Printed: Monday, May 10, 2021 3:03 PM
Date Paid: Monday, May 10, 2021
Paid By: TRI COUNTY ELECTRICAL
Pay Method: CREDIT CARD 454022821
1 of 1
Cashier: CG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R15757
Electrical Permit Application
City of Atlantic Beach Building Department
800 Seminole Rd, Atlantic Beach, FL32233
Phone: (904) 247 -5826 Email: @
JEA INFORMATION REQUIRED ON ALL PERMITS: IAT-AWTPS VOLTS
"....d1!
PHASE
il rrrew sERVrcE:flOverhead frUnderground fliJndergroundupPole
S151-200amps fl_amps
flResidential (Main) Service:
I rvew FEEDER (ADDtloNs, AccEssoRy srRucruREs, ETC.):
[N100 amps ffitsoamps ffizooamps E_-amps fftT service _ amps
E aoottoNs, REM.DELs, REpArRs, BUrLD-ours, AccEssoRy STRUCTURES, ETC:
Outlets/Switches: _0-30a m ps
0-30a m ps
0-60a m ps _61-100a m ps
Heat Circuits: # circuits @ KW
Number of Lighting Outlets, Including Fixtures:
I orrr* ELE.TRT.AL pR.JECTS:
[swimmingPool[Sign flsmokeDetectors (ety)fllransformers KVA IMotors HP
**ALL INFORMATION
Hrcguenruo rru
GRAY IS REqUIRED.
96, ?a'n'** tF;:"|#
PERMIT #:
---
fl0-100amps 8L01-L50amps
ElCommercial (Main) Service:
ilo-1oo amps ffto1-tsoamps
Conductor Type
ffitst-zooamps
Size
fltst-zooamps
ml amps
S-amps
# of Meters
SCT Service _ amps
# of Unit Meters
EMulti-Family (Main) Service;
fr-too amps fl101-t 5oamps
KP#ffi-frl#Jtre^^,,n se nvrcE upGRADE: ! amos ECT Service amps
Applia nces:
A/C Circuits:
3 1-100am ps
3 L-100a m ps
101--200a m ps
10L-200am ps
I rlne ALARM sysTEM (Requires 3 sets of plans]:
Qty _ volts/amps
! nreatns/M IscELLAN EoUS:
!Replace Burnt/Damaged Meter Can
!other:
nsafety Inspection DPanelChange lou to uc
Updated L0/L7/1"8
Permitbecomesvoidifworkdoesnotcommencewithinasixmonthperiod**orki,,,,P"nd.d
readthisapplicationandknowthesametobetrueandcorrect. All provisionsof lawsandordinancesgoverningthisworkwill becompliedwithwhetherspecifiedornot' Thepermitdoesnotgiveauthoritytoviolatetheprovisionsofanyotherstateorlocal lawregulationconstructionortheperformanceof
construction.
owner Name: RIVERSIDE HOMES phone Number: (904) 503-7055
Electrical Company::Tfiie.Qq,,g, .:Ela,qlii0:A!€qllll4.qlO.r+lr..r,o:r:: :,:r.:,.:,:.., :::r: , Office phone:.!9oa1,zoo.soeo FaX.(90a) 260-9688
Co. Address: 11637 East Columbia Park Drive . Jacksonville State: ,EL
EC13.005421
Notarized Signdture of License Holder
before me this f O day
License Holder:Certification/Registration #:
20 .1, ;n the State of Florida, County of bU t/a--Q
Signature of Notary Public.';';;.,.. TAMMY PA--
l'62t-rXo.'r Notarv Dublic ' State of Florida
,i(. A'rij Commission # GG e814so
';ffi($ ryJ;'"l.llltl*'l,lilil
ilunouo iitrougi' Natlonal Notary Assn'
The foregoin
fieersonally Known OR [ ] produced ldentification
Tvbe of ldentification:
TEMP21-0016