NASSAU COUNTY ELECTRICAL PERMIT APPLICATION FOR CONTRACTORS

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BUILDING PERMIT# (Revised 12/31/17) AP# PERMIT # Cost $ Check# Receipt# NASSAU COUNTY ELECTRICAL PERMIT APPLICATION FOR CONTRACTORS 6 TH EDITION (2017) OF THE FLORIDA BUILDING CODE IS IN EFFECT 2014 NATIONAL ELECTRICAL CODE (NFPA 70) IS IN EFFECT THE FLORIDA FIRE PREVENTION CODE 6 TH EDITION IS IN EFFECT Owner s Name (Please Print) Signature Phone: Day ( ) Alternate ( ) Owner s Address: City: State: Zip Code Contractor(Please Print) Signature Business Name (Please Print) Business Address: City: State: Zip Code: State Certification or Registration Phone # ( ) Mobile/Beeper ( ) Fax # ( ) PROPERTY INFORMATION Property Identification Number: - - - - - Subdivision Block Lot Physical Address (Project Site): City: State: Zip Code: SPECIFIC DIRECTIONS TO SITE: ELECTRICAL: Residential Commercial Mobile Home TYPE OF SERVICE: New Change Out Repair/Remodel Re-connect Primary Power Sub-Feed: POWER COMPANY: FPL FPU REA Specific Description of Work: Single Phase Service Three Phase Service Other Below 100 Amps 100 Amps 0 to 150 Amps Res Pool Interior Wiring 150 Amps 151 to 200 Amps Com Pool Re-Wiring 200 Amps 201 to 400 Amps Re-connect Low voltage wiring 300 Amps 401 to 600 Amps Res Change Out/Repair 400 Amps 601 to 800 Amps Com Change Out/Repair 600 Amps 801 to 1000 Amps Tug 800 Amps Temporary Power Wiring Cost Only $ 1000 Amps Total Job Estimated Construction Cost $ If the estimated cost of this job is greater than $2,500 and not related to a Building Permit, a certified copy of the recorded Notice of Commencement must be filed with the Building Department prior to your first inspection.

NASSAU COUNTY BUILDING DEPARTMENT 96161 Nassau Place, Yulee, Florida 32097 904-530-6250 or 800-948-3364 EARLY POWER AGREEMENT COMMERCIAL RESIDENTIAL (CHECK ONLY ONE) Electric power is requested now under conditions and terms of this fully executed Agreement and Release. Electric Permit No. Building Permit No. Job Site Address Power Company Service: Overhead Underground Tug 1. Early Power per Section 112 of the 6 th Edition (2017) Florida Building Code is purely for our construction convenience, is not required by Codes, does not substitute for Final Inspections or the C/O (Certificate of Occupancy) that must be issued before occupancy: and 2. ON COMMERCIAL JOBS ONLY: Nassau County requires an APPROVED Pre-Power Inspection 3. ON RESIDENTIAL PROJECTS ONLY: Nassau County requires Completion of Drywall and a APPROVED Meter Set Inspection. 4. Occupancy or permanent intended use of the new construction BEFORE a formal C/O constitutes fraudulent use of the early electric service, is expressly prohibited and penalized by Nassau County Ordinances, would be a violation of this Agreement and result in a County request for prompt removal of electric service per Section 112 of the 6 th Edition 2017 Florida Building Code. 5. Early Power release authority and liability is the Electrician s and approval will not occur before: a. Equipment, devices and fixtures are installed or blanked off safely, and b. Panel is complete with breakers and cover, and (Labeling required at Final Inspection) c. Service connection and grounding is complete, and d. The electric system has safely passed a thorough electrical check, (tug service check consist of meter can with GFI receptacles) 6. Any unpaid fees and unsatisfied requirements will block power release. 7. This fully completed form is to be submitted to the Nassau County Building Department as the Request Release for Early Power either by hand, mail, email or fax. Future POWER Agreements WILL NOT be accepted from those who violate any one of the 7 items above BUILDING CONTRACTOR NAME (Print) TELEPHONE SIGNATURE ADDRESS: ELECTRICIAN NAME (Print) TELEPHONE SIGNATURE ADDRESS DATE 12/31/17

NOTICE OF COMMENCEMENT FS 713.13 REVISED 1/3/12 MUST BE RECORDED AT THE NASSAU COUNTY CLERK S OFFICE Property Appraisers Parcel Identification: NOTICE OF COMMENCEMENT The undersigned hereby given notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes the following information is provided in this Notice of Commencement. Legal description of property (include street address, if available) General description of improvements Owner s Name Address Owner s Interest in site of the improvement Fee Simple Title holder (if other than owner) Address Phone: Fax: Contractor Address Phone: Fax: Surety Phone: Fax: Address Amount of Bond $ Lender s Name Address Phone: Fax: Expiration date of notice of commencement (the expiration date may not be before the completion of construction and final payment to the contractor, but will be 1 year from the date of recording unless a different date is specified),.20 WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13, FLORIDA STATUTES, AND CAN 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 COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best of my knowledge and belief. Signature of Owner or Owner s Authorized Officer/Director/Partner/Manager Print Name and Provide Signatory s Title/Office I have relied upon the following identification of the Affiant Sworn to and subscribed before me this day of Notary Signature Printed Name

NOTICE OF COMMENCEMENT FS 713.13 REVISED 1/3/12 MUST BE RECORDED AT THE NASSAU COUNTY CLERK S OFFICE Property Appraisers Parcel Identification: NOTICE OF COMMENCEMENT The undersigned hereby given notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes the following information is provided in this Notice of Commencement. Legal description of property (include street address, if available) General description of improvements Owner s Name Address Owner s Interest in site of the improvement Fee Simple Title holder (if other than owner) Address Phone: Fax: Contractor Address Phone: Fax: Surety Phone: Fax: Address Amount of Bond $ Lender s Name Address Phone: Fax: Expiration date of notice of commencement (the expiration date may not be before the completion of construction and final payment to the contractor, but will be 1 year from the date of recording unless a different date is specified),.20 WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13, FLORIDA STATUTES, AND CAN 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 COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Under penalty of perjury, I declare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best of my knowledge and belief. Signature of Owner or Owner s Authorized Officer/Director/Partner/Manager Print Name and Provide Signatory s Title/Office I have relied upon the following identification of the Affiant Sworn to and subscribed before me this day of Notary Signature Printed Name

Nassau County Building Department Inspection Types February 9, 2018 ALL INSPECTION REQUESTS ARE REQUIRED TO BE INITIATED BY THE PERMIT HOLDER, ALL INSPECTION REQUESTS SHALL SUPPLY THE PERMIT NUMBER FOR EACH TRADE REQUESTED, THE TYPE OF INSPECTION, THE NAME OF THE INDIVIDUAL MAKING THE REQUEST AND A TELEPHONE NUMBER WHERE THE INDIVIDUAL CAN BE REACHED IF NECESSARY. THE FOLLOWING IS A LIST OF THE ELECTRICAL INSPECTIONS PERFORMED BY THE NASSAU COUNTY BUILDING DEPARTMENT WITH A BRIEF DESCRIPTION OF THE PURPOSE FOR THE INSPECTION INSPECTIONS REQUESTED FOR THE FOLLOWING WORK DAY MUST BE CALLED IN PRIOR TO 4:00 P.M. THE DAY BEFORE. TYPE DESCRIPTION 210 ELECTRICAL TEMPORARY: This inspection is made after the temporary pole or temporary installation is complete and before the meter is set and power connected. 215 TUG (Temporary Underground Service) TEMPORARY: This inspection is made after the temporary service that is installed on the structure and connected to a GFCI protected quad receptacle is complete. A TUG installation SHALL NOT be connected to the house panel until a 260 Meter Set Inspection has been approved. 220 ELECTRICAL CEILING COVER UP: This inspection is made after any raceway wiring and/or junction boxes are installed that may be covered up by construction material. (May also be called a Rough Electrical Ceiling Only ) (NOTE: Conduit or raceway without electrical wiring is not a required inspection). 240 POOL ELECTRICAL: This inspection is made after all electrical conduit, bonding devices for the re-enforcement, niche and lighting fixtures are installed and before any cover of concrete is placed or shot. (If electrical is complete a (299) electrical final must also be set up with the 240) 250 ELECTRICAL ROUGH: This inspection is made after all conductors (wires) are installed and before any covering is completed. (This inspection is to determine if the correct size wire is used, the correct fastening is used and the appropriate circuits have been installed)

2 252 - LOW VOLTAGE ELECTRICAL ROUGH: This inspection is made after all conductors (wires) are installed and before any covering is completed. 260 ELECTRIC METER SET: This inspection is made after all electrical components are in a safe condition with all required grounding in place, has a signed pre-power agreement and is utilized to have electrical power for the purpose of hot checking appliances and circuits. (THIS IS NOT A FINAL ELECTRICAL INSPECTION). 290 ELECTRIC PRE-POWER: This inspection is made on commercial electrical installations for the purpose of determining that the installation is safe, has a signed pre-power agreement and is utilized for the purpose of checking out the electrical components, appliances and equipment prior to a final electrical inspection. (This is NOT a final electrical inspection) 299- ELECTRICAL FINAL/CHANGE OUT: This inspection is made after all components, fixtures, equipment and appliances indicated on the approved construction drawings have been installed and the electrical system is in a complete, safe and code compliant state and ready to be used. FINAL INSPECTIONS ARE REQUIRED ON ALL PERMITS. FAILURE TO OBTAIN FINAL INSPECTION MAY RESULT IN ADDITIONAL FEES