1832 OCEAN GROVE DR ERES23-0278 Electrical Permit Application **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
' 800 Seminole Rd, Atlantic Beach, FL 32233
. . Phone: (904) 247-5826 Email:: Building-Dept@coab.us PERMIT#: ERES .Z3-UZ7�
JOB ADDRESS: / 3Z-- Cr"") ce_0.n (Th ,r-r,V PROJECT VALUE $ 7 000
JEA INFORMATION REQUIRED ON ALL PERMITS: t5 AMPS .z.c(-p VOLTS 2- PHASE
I NEW SERVICE: ❑ Overhead ❑Underground ❑Underground up Pole
❑Residential (Main)Service:
❑0-100 amps o101-150amps n151-200amps ❑ amps #of Meters
nCommercial(Main) Service:
❑0-100 amps o101-150amps o151-200amps o amps ECT Service amps
Conductor Type Size
h Multi-Family(Main)Service:
❑0-100 amps o101-150amps o151-200amps ❑ amps #of Unit Meters
TEMPORARY POLE: amps
SERVICE UPGRADE: ❑ amps ECT Service amps
i I NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
❑100 amps ❑150amps ❑200amps o amps ❑CT Service amps
I 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:
al OTHER ELECTRICAL PROJECTS: U
❑Swimming Pool Sign Smoke Detectors I (Qty) ❑Transformers KVA DMotors HP
FIRE ALARM SYSTEM (Requires 1 set of digital plans):
Qty volts/amps
REPAIRS/MISCELLANEOUS:
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection , anel Change 'DOH to UG
JOther: /eICu 4 til'r•
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 he 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: /-Aa5 PI"„ 5.✓ Phone Number: 957 '—Z iC t
Electrical Company: 4 v,c-4 aI Office Phone: 76 3 - `1617 Fax:
Co.Address: C1/5 �� 4do. /V 1.— City: IDD X,,<4 State: FTC_Zip: 3z Z ce
License Holder: / „, /�,`/j 11- _ State Certification/Registration#: EL/ 3 0/-5-7Z 9
Notarized Signature of License Holder li ,,
dre
The foregoing instrument was acknowled d bef - this I-day of Otpyvi�'Ii Y,20 Z3 in the State of Florida, County of 00 1k1I
Signature of Notary Public 14,---
r ' •; LADAYIJANICHOLS
;+ ,'; 1 MYCOMMISSION#HH226065 [ ] Personally Known OR[ Pro*uced Identification
_?•• Type of Identification: -,VP V J e.
+,*�oPP; EXPIRES:February 8,2026 YP Imo\ Q.111`�