1085 ATLANTIC BLVD UNIT 22 ELPP22-0017 Electrical Permit Application **ALL INFORMATION
HIGHLIGHTED IN
170.:.:,, City of Atlantic Beach Building Department GRAY IS REQUIRED.
- ' ,:,) 800 Seminole Rd, Atlantic Beach, FL 32233 Eft f PZZ _c3c)
Phone: (904) 247-5826 Email: Buildin.-/Deet • coa'.0 , 2-T PERMIT#: 40
JOB ADDRESS: / 0 is C 4 Hcc frL�(L ( Y� PRO ECT VALLUEE$$ /.5z1
JEA INFORMATION REQUIRED ON ALL PERMITS: /00 AMPS Z/UVOLTS ( PHASE
I I NEW SERVICE: ❑ Overhead ❑Underground ❑Underground up Pole
LResidential (Main)Service:
❑0-100 amps o101-150amps o151-200amps ❑ amps #of Meters
Commercial (Main) Service:
❑0-100 amps o101-150amps 0151-200amps o amps ❑CT Service amps
Conductor Type Size
❑Multi-Family(Main)Service:
0-100 amps o101-150amps o151-200amps o amps #of Unit Meters
TEMPORARY POLE: amps
SERVICE UPGRADE: r-, amps nCT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
❑100 amps ❑150amps 1200amps ❑ amps oCT Service amps
ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 0-30amps 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 _
Y`' REPAIRS/MISCELLANEOUS:
,Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH 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.
Owner Name: N (' ,�n
t ` (.-LC— Phone Number:
Electrical Company: DV VJ e/ed-r-i�/ Office Phone: 90/76 7 ?L? Fax:
Co.Address: --7p 3 WO Utz &f.-7 72r- City: ()A_C 5.)x.,ia c. State: 1 Zip: 7 221r
License Holder: / State State Certification/Registration#: '0,.— / 300 8'6 �''47
Notarized Signature of License Holder _$ .__ ,L/ !�J
The foregoing instrument was acknowledged before me this2ay of ►.5# s R i.• he State of Florida,County of Z D IRS
c
4,7g,:ii ;, TONIGINDLESPERGER Signature of Notary Public 0 V
"A',., MY COMMISSION#GG 353178
. ia .
, .���.4 EXPOS:October 6,2023 y]-Perconally Known ORI ] Produced Identification
''Z'f—vg$' gandedThruNotary PublcUndxwrftere ' Type of Identification: