224 S OCEANWALK DR ERES22-0257 /;s, Electrical Permit Application HIGHLIGHTED
" **ALL INFORMATION
''' City of Atlantic Beach Building Department GRAY IS REQUIRED.
\' 800 Seminole Rd, Atlantic Beach, FL 32233 t
\` =''"`.)~ Phone: (904) 247-5826` Ij
Email: Building-Dept@coab.us PERMIT#: EREg 2Z-(5Z.5^
JOB ADDRESS: 2Z '7 DGii g Glia.-/k ,l/-( Sal.-/11 PROJECT VALUE $ 1/ 000
i2c -2 yo
JEA INFORMATION REQUIRED ON ALL PERMITS: ZOO AMPS VOLTS / PHASE
❑ NEW SERVICE: ❑ Overhead ❑Underground ❑Underground up Pole
t Residential(Main)Service:
���� 100 amps o101-150amps o151-200amps ❑ amps #of Meters
❑CoInmercial(Main)Service:
❑0-100 amps E101-150amps E151-200amps ❑ amps ECT Service amps
Conductor Type Size
❑Multi-Family(Main)Service:
❑0-100 amps o101-150amps E151-200amps ❑ amps #of Unit Meters
n TEMPORARY POLE: amps
❑ SERVICE UPGRADE: ❑ amps DCT Service amps
❑ NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
❑100 amps ❑150amps I i200amps ❑ amps ❑CT Service amps
LTL ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches627/ 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
n FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
❑ REPAIRS/MISCELLANEOUS:
❑Replace Burnt/Damaged Meter Can ❑Safety InspectionLanel Change EOH 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 doeslnot give authority to violate the provisions of any other state or local law regulation construction or the performance of
OwnercCanm.
e: G-Dt€f/e a 7 yt (4/ 'f) 7zY-U1,9
Phone Number: �•
Electrical Company: old//7 4, r Office Phone: Fax:
Co.Address: / , City: State: Zip:
i
License Holder LA i / Al /, —0 A . tate Certification/Registration#:
Notarized Signature of License Holder
The foregoing instrument was acknowledged before me thisay of a 0%), :.. , - State of lorida,County of Off Qa--
Signature of Notary Public _ As
S. , . awt
P TONI GINDLESPERGER
7.•:=orPersonally Known OR( j Pr 'fie• Identifica i.
A.:,--.3 MY COMMISSION#GG 353178 Type of Identification:C+i EXPIRES:October 6,2023
-°r vy; Bonded Thru Notary Public Underwriters