444 Whiting Ln ERES21-0302 App Electrical Permit Application **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 2
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:treSZ/—O )O)
JOB ADDRESS: . -t cunt 11,k) 1 J • PROJECT VALUE $ 1 5b0. O '
JEA INFORMATION REQUIRED ON ALL PERMITS: ta AMPS lir VOLTS . PHASE
NEW SERVICE: - Overhead ❑Underground uUnderground up Pole
HResidential (Main) Service:
❑0-100 amps o101-150amps o151-200amps ❑ amps #of Meters
❑Commercial (Main) Service:
❑0-100 amps L101-150amps o151-200amps ❑ amps [ACT Service amps
Conductor Type Size
❑Multi-Family(Main)Service:
❑0-100 amps ❑101-150amps n151-200amps ❑ amps #of Unit Meters
TEMPORARY POLE: amps
SERVICE UPGRADE: a amps [ACT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
❑100 amps 17150amps i 200amps i amps ❑CT 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:
nSwimming Pool Sign Smoke Detectors (Qty) ❑Transformers KVA ❑Motors HP
FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
REPAIRS/MISCELLANEOUS:
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ¢Panel Change ❑OH to UG
nOther: \\ 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: I`pv't().'t'+Jt A frro Phone Number: q05-^ (0717
Electrical Company: 131,A 44 kt-24,1(1.iC Or TO <fip5 Office Phone: 461f-2-KG' 'tb $S'� Fax:
ci
Co.Address: (02�' f1 AVE n)< ^43 tfr4
r7l1 City: J 6t,14 State: FL Zip: �z-?�
License Holder: �idVIA'SO.J B_ I State Certification/Registration#: 13oO-739N
Notarized Signature of License Holder `"" Al`) 10 f Fff
The foregoing instrument was acknowledged before me this / 7 day of (i ,2021, in the State f F orida,County of L U v4 (_
Signature of Notary Public L
t'1!Y Ptd,••, CHRISTIAN GILES
• : MY COMMISSION#HH 117153
,•'.: ,* ., [ ] Personally Known OR[ pdcedIdentification
::9`4: EXPIRES:April 13,2025 Type of Identification: / L
.•• F��,l•• Bonded TAN Notary PUDMC Uflder.vrlI J