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1755 Beach Ave ERES21-0283 App itemp,, Electrical Permit Application **ALLINFORMATION AlkHIGHLIGHTED IN A '',ig City of Atlantic Beach Building Department GRAY IS REQUIRED. A"tztialp 800 Seminole Rd, Atlantic Beach, FL 32233 ep ES71 — 0 2'3 Phone: (904) 247-5826 Email: Building-DeptPcoab.us PERMIT#: IESA Z-1 - 00$ C) JOB ADDRESS: 1.15-5- 1-5-1tCK AVE- PROJECT VALUE $ / 5-00 12-0 n JEA INFORMATION REQUIRED ON ALL PERMITS: 20 AMPS (0 VOLTS - PHASE ❑ NEW SERVICE: 0 Overhead ®Underground ®Underground up Pole (®Residential(Main)Service: 00-100 amps 1:1101-150amps r1151-200amps _amps #of Meters CJCommercial(Main)Service: 00-100 amps 0101-150amps 1E1151-200amps la_____amps OCT Service amps Conductor Type Size ®Multi-Family(Main)Service: 00-100 amps ®101-150amps ®151-200amps © amps #of Unit Meters 11 TEMPORARY POLE: amps ❑SERVICE UPGRADE: ❑ amps OCT Service amps n NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.): 0100 amps 10-150amps D200amps 0 amps OCT Service amps B ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC: Outlets/Switches: Z— 0-30a mps 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 ESign ❑Smoke Detectors _(Qty) ❑Transformers KVA OMotors HP n FIRE ALARM SYSTEM (Requires 3 sets of plans): Qty volts/amps LI REPAIRS/MISCELLANEOUS: ❑Replace Burnt/Damaged Meter Can ❑Safety Inspection [Panel Change DOH to UG ❑Dther: 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:_\`) 73INI°t1V5UN i-\i11LO 12.07- /p Phone Number: ( /011 73-41-7 6 60 Electrical Company: p 3 L E Ez:rr.ic A L roki-rittleTeVfice Phone:(9cx-/13/L,1 Z' Fax: Co.Address: 0:)4)0 30 biz_if LI City: .. 14kc CxNvt LLC- State: FL Zip:3'u i I( License Holder: >UY111.: Uu"f _I -C , ., State Certification/Registration#: e I 3°015 1 v Notarized Signature of License Holder .� L7 ., % The foregoing instrument was acknowle5lgedibefore me this?0 day of O V ,2021 in the 5 e_of Florida,County of . .;:p�"v . CHRISTIAN GILES Signature of Notary Public ( - l/L— ., /h ...I MY COMMISSION#HH 117153 '-.;;;,,..,1.,: i EXPIRSS:ApdI13,2025 I ] Personally Known OR(Produced Identification "'•_____ BondedTbruNotary Public undawrkers Type of Identification: Ft— r)_ l,--