Loading...
1018 MAIN ST ERES22-0007 ERESZ•Z- boo? i,:oV-Ait Electrical Permit Application **ALL INFORMATION HIGHLIGHTED IN i� City of Atlantic Beach Building Department GRAY IS REQUIRED. 800 Seminole Rd, Atlantic Beach, FL 32233 / ';"rPhone: (904) 247- 826 Email: Building-Dept@coab.us PERMIT#: /Cf5/.-- JOB ADDRESS: fel C f) 1' e-(N 5.&`x.6 PROJECT VALUE$ 0C) oZ JEA INFORMATION REQUIRED ON ALL PERMITS: '800 AMPS a0 VOLTS / PHASE ❑ NEW SERVICE: ❑ Overhead ❑Underground ❑Underground up Pole ❑Residential (Main)Service: ❑0-100 amps D101-150amps ❑151-200amps ❑ amps #of Meters ❑Commercial(Main)Service: ❑O-100 amps E101-150amps ❑151-200amps ❑ amps ECT Service amps Conductor Type Size ❑Multi-Family(Main)Service: ❑O-100 amps D101-150amps o151-200amps ❑ amps #of Unit Meters (1 TEMPORARY POLE: amps ❑ SERVICE UPGRADE: ❑ amps ❑CT Service amps ❑ NEW FEEDER(ADDITIONS, ACCESSORY STRUCTURES, ETC.): ❑100 amps ❑150amps ❑200amps ❑ amps DCT Service amps ❑ ADDITIONS, REMODELS, REPAIRS, BUILD-UTS,ACCESSORY STRUCTURES, ETC: Outlets/Switches: 0-30amps 31100amps 1O1200amps Appliances: . 0-30amps 31-100amps 101-200amps A/C Circuits: 0-60amps 61-100amps Heat Circuits: # circuits @ kw Number of Lighting Outlets, Including Fixtures: CI ❑ OTHER ELECTRICAL PROJECTS: ❑Swimming Pool :Sign ESmoke Detectors (Qty) ❑Transformers KVA ❑Motors HP ❑ FIRE ALARM SYSTEM (Requires 3 sets of plans): Qty volts/amps n REPAIRS/MISCELLANEOUS: ❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change DOH 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 n give authority to violate the provisions of any other state or local law regulation construction or the performance of construction. q, Owner Name: C p�0�/,.�JGZc)IC o f . Phone Number: Jpc�7 [0R-Ci Electrical Company: ��f" �` ��C (c/`< < Office Phone: 1' ��j 7� / Fax: Co.Address: �� ���� � (� CX City: K„\it,-v�J(./4- State: P7"P7" �O3 Zip: ' License Holder: C R tC- ir\A • iR ©nC\a C\"AState Certification/Registration#: Notarized Signature of License Holder . �� The foregoing instrument was acknowledged before me this I Zday of G . \ , k it• a State of Florida,County of Q,i�/a Signature of Notary Public 9 i ;'�••"'•�c, TONI GINDLESPERGER ] Personally Known OR[ 1 Produced Identification *i TA'' ;, MY COMMISSION#GG 353178 ype of Identification: (_ =a. IIIA' rF.F.'P EXPIRES:October 6,2023 ., `�' Bonded Thru Notary Public Underwriters