1021 ATLANTIC BLVD 971 ELPP24-0059 Cowl
,,,si�i, ELECTRICAL PERMIT APPLICATION FOR INTERNAL OFFICE USE ONLY
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s, City of Atlantic Beach Building Department PERMIT# ��r P24 –
800 Seminole Road, Atlantic Beach, FL 32233 **ALL information required to process
trot.)%' V Phone: (904)247-5826 Email: Building-Dept@coab.us
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JOB ADDRESS /02/ /1-¢`Gyt/cC /g(//1 9,,,,k 57/ PROJECT VALUE $ // coo
JEA INFORMATION REQUIRED ON ALL PERMITS: AMPS /00 VOLTS 2 ) PHASE /
❑ NEW SERVICE: ❑ Overhead ❑ Underground ❑ Underground up Pole
❑ Residential (Main) Service:
❑ 0-100 amps ❑ 101-150 amps ❑ 151-200 amps ❑ amps #of Meters
❑ Commercial (Main) Service:
❑ 0-100 amps ❑ 101-150 amps ❑ 151-200 amps ❑ amps ECT Service amps
Conductor Type Conductor Size
❑ Multi-Famil (Main) Service:
❑ 0-100 amps ❑ 101-150 amps ❑ 151-200 amps ❑ amps #of Unit Meters
❑ TEMPORARY POLE: amps
❑ SERVICE UPGRADE: ❑ amps ECT Service amps
❑ NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
❑ 100 amps ❑ 150 amps ❑ 200 amps ❑ amps ❑ CT Service amps
❑ ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS, ACCESSORY STRUCTURES, ETC:
iiip Switches: 1p 0-30 amps 31-100 amps 101-200 amps
Appliances: 0-30 amps 31-100 amps 101-200 amps
A/C Circuits: 0-60 amps 61-100 amps
Heat Circuits: #circuits @ kw #of Lighting Outlets, Including Fixtures:
❑ OTHER ELECTRICAL PROJECTS
Generator ❑ Whole house (ATS) or [' Stand alone ❑ Swimming Pool ❑ Sign
❑ FIRE ALARM SYSTEM (Requires 1 set of digital plans):
Quantity volts/amps
❑ REPAIRS/MISCELLANEOUS:
❑ Replace Burnt/Damaged Meter Can ❑ Safety Inspection ❑ Panel Change ❑ OH to UG
❑ Other:
NOTICE: Permit becomes expired if work does not commence within a six month period or work is suspended or abandoned for six
months. 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.
PROPERTY OWNER Name Phone
ELECTRIC COMPANY Name lkNo E:1‘24--"(CJ / Phone $'e 707.meq t(
Address -7(e,3 cock: f2 .7 Or • City ��SUS• vi / (p State Zip
License Holder c, v r� State Certification/Registration# 'E— / 0.0 &' g7
"In lieu of signed,shorn and notarized signatures of the property owner, agent and/or contractor, and under penalties of
perjury, I dec r that I have ead and examined the foregoin application and that the facts stated in it are true and correct."
72,/,,
SIGNATU CONT OR PRINT OR TYP NAME OF CONTRACTOR DATE