812 Ocean Blvd ERES22-0086 Revision 9-22-23 ALL
Revision Request/Correction to Comments **HIGHLI HIGHLIGHTED
ON
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
Iric;1,
y 800 Seminole Rd, Atlantic Beach, FL 32233 .
-4aais`• Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:Lt
LJa Revision to Issued Permit OR ❑ Corrections to Comments Date: q :., L--,j0J
Project Address: U / OC-. A) 6614 1
Contractor/Contact Name: Y �, .., it6V J
Contact Phone: 'it' `-V 38 Z y$ II Z. Email: T c IT G/ •„✓Ste. Fi ec."1-,,,4110 cipy S20 / `1 4,4tee /y�
A4ee', G47
Description of Proposed Revision/Corrections:
[met 4.4 j. e s!iee.J Foy a ieCOAztie V i iM,id Not Hvvr�
e�e/1 t G°j-14,18 07. P,otcc £k29I4 3, NE O p fa c ttet ik e re, 14%
C'O/4 LUPI 2-.4i d V ,%. v', P
I V-ii e. L c tJS affirm the revision/correction to comments is inclusive of the proposed changes.
(printed name)
• Wiyproposed revision/corrections add additional square footage to original submittal?
No ❑ Yes (additional s.f.to be added:
• Wijl proposed revision/corrections add additional increase in building value to original submittal?
No ❑*Yes (additional increase in building value: $ ) (Contractor must sign if increase in valuation)
*Signature of Contractor/Agent:
(Office Use Only)
❑ Approved ❑ Denied ❑ Not Applicable to Department Permit Fee Due$
Revision/Plan Review Comments
Department Review Required:
Building
Planning&Zoning Reviewed By
Tree Administrator
Public Works
Public Utilities
Public Safety Date
Fire Services Updated 10/17/18
Electrical Permit Application **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 n
Phone:Q (904) 247-5826 Email: Fuilding-Dept@coab.us PERMIT#:
JOB ADDRESS: p C^ ',t�r\ i iA PROJECT VALUE$ 3, O�'
JEA INFORMATION REQUIRED ON ALL PERMITS: 800 AMPS:40 VOLTS_m_-PHASE
NEW SERVICE: Overhead oUnderground DXUnderground up Pole
Residential (Main)Service:
❑0-100 amps o101-150amps o151-200amps )r0 BOO amps #of Meters i
_Commercial (Main)Service:
❑0-100 amps 101-150amps o151-200amps ❑ amps oCT Service amps
Conductor Type Size
-.Multi-Family(Main)Service:
0-100 amps o101-150amps o151-200amps ❑ amps #of Unit Meters
TEMPORARY POLE: amps
SERVICE UPGRADE: ❑ amps oCT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
-100 amps :::150amps :200amps r amps CT Service amps
I 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:
oSwimming Pool Sign oSmoke Detectors (Qty) ❑Transformers KVA oMotors HP
FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
1 ) REPAIRS/MISCELLANEOUS:
Replace Burnt/Damaged Meter Can oSafety Inspection oPanel Change ❑OH to UG
uOther: 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: 3c<c k Phone Number: rkht-3$2-95'92
Electrical Company: C r P[(AS EI e c_-(':C.c+�� C r,,n C.',11 Office Phone: 9O y'S20 )4(o9 Fax:
Co.Address: 157 7 9' .S I.E[IG(GC�f r' rd City: Tc,.(`k.',nrw;I IF State: FL Zip: e222./v
License Holder: • I Stat• Ce ification/Registration#: EC-00025-3 4
Notarized Signature of License Holder �►/kvi
+�
The foregoing instrument was acknowl•.ged before me this 2 22'ay of 3 I,20 in he State of Florida,County of vo,l
Signature of Notary Public
' RV PU'• f"
VANESSA ANGERS
IN ;•_ MY COMMISSION M HH 244118 [ ]Personally Known OR [ oduced Identification
Type of Identification: FL O C- ac k l.,\)• LIw
eS
FbF F`oa; EXPIRES:March 23,2026