Loading...
Permit 1070 Ocean Blvd `; CITY OF ATLANTIC BEACH ; 800 SEMINOLE ROAD Jr ti w ATLANTIC BEACH, FL 32233 ° INSPECTION PHONE LINE 247 -5826 ' Application Number 10- 00000427 Date 8/05/10 Property Address 1070 OCEAN BLVD Application type description RESIDENTIAL ALTERATION Property Zoning TO BE UPDATED Application valuation . . . 167500 Application desc REMODEL KITCHEN /BATH,SIDING NO ADDL SQ FT Owner Contractor MOODY OWNER ATLANTIC BEACH FL 32233 Permit MECHANICAL GAS PIPE PERMIT Additional desc . Permit Fee . . . 119.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 2/01/11 Special Notes and Comments *2007 FLORIDA BUILDING CODE W/'05 -'06 SUPPLEMENTS. 2007 FLORIDA BUILDING CODE - RESIDENTIAL. 2005 NATIONAL ELECTRICAL CODE. *SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST CONTROL COMPANY PRIOR TO C.O. *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS Fee summary Charged Paid Credited Due Permit Fee Total 119.00 119.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 119.00 119.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. Jul 29 10 03:08p Information SystemsClTY 0 904- 247 -5845 p1 MECHANICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph (904) 247 -5826 Fax (904) 247 -5845 JOB ADDRESS: 1010 Ocean fSlvd PERMIT # Io - ya? PROJECT VALUE $ $ L, 000. NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION Air Conditioning: Unit Quantity Tons Per Unit . Heat: Unit Quantity BTU's Per Unit Seer Rating Duct Systems: Total CFM REQUIRED REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI 4 Air Conditioning: Unit Quantity Tons Per Unit NEUTRITI Heat: Unit Quantity BTU's Per Unit Seer Rating Duct Systems: Total CFM REQUIRED FIRE PREVENTION Fire Sprinkler System Quantity (Requires 3 sets of plans) Fire Standpipe Quantity (Requires 3 sets of plans) Underground Fire Main Value (Requires 3 sets of plans) Fire Hose Cabinets Quantity (Requires 3 sets of plans) Commercial Hoods Quantity (Requires 3 sets of plans) Fire Suppression Systems Quantity (Requires 3 sets of plans) FIRE PLACES MISCELLANEOUS: Prefabricated Fireplace Qty l Automobile Lifts Gas Piping Outlets ____L____ Boilers BTU's Elevators/Escalators ALL OTHER GAS PIPING Heat Exchanger Quantity of Outlets 5 Pumps # Vented Wall Furnaces Refrigerator Condenser BTU's 4 Water Heaters 1 Solar Collection Systems Tanks (gallons) a 50 Sal s f n owt. Wells OTHER: 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 be true and correct Ali 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. Property Owners Name D0K9 11f1 eddy Phone Number 8 14 - 739~5 Mechanical Company H elri •fa9e. & &Paste p6R : Sou re d as Office Phone 2 '1 -6 Y11 Fax vt .-oi Co. Address: ' : P , 1 . ,,dl. ity Titeksonvtqk &aA State pi. Zip 3 __ Z t License Holder (Print): 1/1 i k Trove loci d • , rte Certification/Registration # i(95 Notarized Signature of License Holder / . S w o r n and subscri. - • i orreey this a 9 day of - 1-- 20 lO Signature of Notary Public l ? r +`-e. J r1 MAC E. MEHAFFE`( ; � .. MY C :Gtmassf• a 'D 907379 r EXPIRES, ; itr ;,: 20 • iil Bonded Thru Notary Pubtn. underwriter i • CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 Application Number 10-00000774 Date 6/21/10 Property Address 1070 OCEAN BLVD Application type description RIGHT-OF-WAY PERMIT Property Zoning TO BE UPDATED Application valuation 0 ---------------------------------------------------------------------------- Application desc lower ground 11th and ocean ---------------------------------------------------------------------------- Owner ------------------------ MOODY DOUGLAS AND LINDA 1070 OCEAN BLVD ATLANTIC BEACH FL 32233 Contractor ------------------------ OWNER Permit DRIVEWAY PERMIT Additional desc LOWER MOUNT CORNER 11TH & OCN Permit Fee .00 Plan Check Fee .00 Issue Date 6/21/10 Valuation 0 Expiration Date 12/18/10 ---------------------------------------------------------------- Special Notes and Comments All dirt/etc. must be swept from street. Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- --- Permit Fee Total .00 .00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total .00 .00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORH)A BUILDING CODES. -t~~1~;yJ, City of Atlantic Beach ~ " ~'~ "'~~~ ' . /~ .`':;:;, zl Buii~BirDg ®epartrnent i ,}UN t 5 ~~'~r) -' ~e~.~ 800 Seminole Road ~ ' '' ~~ '' ' r~ Atlantic Beach, Florida 32233-5445 1, ~ ~` Phone (904) 247-5826 Fax (904) 24`T x$45 \ -~ "~Jtt ~%~ E-mail: building-dept@coab.us ~` City web-site: http://www.coab.us APPLICATION NUMBER (To be assigned by the Building Department.) ~~ Date routed: APPL~CA1°I®6V ~:~V1~1n/ ,P-N® ~'~AeCKI~IG F®~~I 9p®perty A~9dress: /~ ~~ ~C~~a.~ 0U~ -pplccas>It: CJ ~ ~~ /C 'r®ject: -~~~~ ~dL~r~~ C.l-o~~~~ - - ®epartrroent review required Yes No Building Planning & Zoning Tre ' trator ublic Works u is Utiliti Public Safety Fire Services I~ev~ew'fee>~r~°~~,` ~ ~ '~ ;,:;~. ~Dept=S gnature t, ,-. ~~~ .:~.~ ,• Other Agency Review or Permit Required Review or Receipt of Permit Verified By Date Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: Reviewing Department (Circle one.) BUILDING PLANNING & ZONING TREE ADMIN. .~ P 1plORKS TIL /e P U I C FETY FIRE SERVICES APPLICATION STATUS First Review: []Approved. ^Denied. Comments: ( " Reviewed by: Date: ~'~7'~~ Second Review: ^Approved as revised. ^Denied. Comments; Reviewed by: Third Review: Comments: ^Approved as revised Date: °""PILE COPY Reviewed by: Date: Revised 05/14/09 ., r•~=s~'y:rj~,,~ City ®f ~.tlar~tic i3each ~ _~ ~; ~ ,a," ` , ., , ~, , , ° ;.- • z, i3ui6ding ®epartaner~t I , i °` ~~:~ 80D Seminole Road ~UN ~ ~ ~I.~Q ` ,~a r} y-•- r Atlantic Beach, Florida 32233-5445 1 ~ _^~~`` ~ Phone 904 247-5826 Fax 9D4 ~ ;.. . ~ ) ~ ) ;2~~ 5845 ~~xt ~r E-mail: build'mg-dept@coab.us ~:_- -_.._ -- - City web-site: http://www.coab.us APPLICATION NUMBER (To be assigned by the Bu7ilding Department.) Date routed: /~~ '~®perty A~~re~s: rD ~D D~~~ ~ ~'/U~ ~ppllcac~t: ~ ~ ~~ /G i7epartanec~t review required Yes No Building Planning & Zoning Tre ' trator ublic Works U IC Utllltl Public Safety Fire Services °""~~`- ~'a'r"T"3a~n--^ai; r^z~~.s -~- ..-.--, '"-"rT- -•.°•^.-fix `- -1'-~-~'n'-'"~^~ _ -"°ra-~^'- Revievu~, eet~:~ ~ ~u~ ~ x,~ r .~ ~y, ..._.~~ ~.~~ r ~~~..~~ Dept°Slgna~ture~~E a~~ ~ ~~..~ ~~>~~~w. ~~...` '~£~ Other Agency Review or Permit Required Review or Receipt of Permit Verified ~y ®ate Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATIOM STATUS Reviewing Department First Review: Approved. ^Denied. (Circle one.) C mments: ^+, BUILDING ~ --• /~ l / ~i ,Y,~/~1h . ~, ~s ~. ~ l t~,~~ ~~-- ~4 PLANNING & ZONING Reviewed by: ~ Date: ~9 TREE ADMIN. PUBLIC WORKS PUBLIC UTILITIES PUBLIC SAFETY FIRE SERVICES Second Review: ^Approved as revised. ^Denied. Comments: Reviewed by: Third Review: ^Approved as revised. ^Denied. Commerts: E C P~ Reviewed by~ ~~ Date: Date: Revised D5/14I09 Date: ~ f ~ ~ ~ ~ ~ Public Works Plan Review Comments Project Name/Address: ~ ~~ b acP.GL~ ~ I ~~ ~~ xo Initials- i `ice Application~ermit #: ~o. 6~7~ Check Boz Application Tracking Comments to Add: Comment Provide impervious surface calculations. ^ Provide erosion and sediment control plans with installation. details and maintenance ^ schedule. Provide drainage plans showing site topography (flow arrows, etc.) ^ Provide construction site management plan, including Right-of--Way Permit if using ^ ri ht-of-wa for construction arkin . Provide apre-construction topographic survey prepared by a Florida Licensed ^ Professional Land Surve or, showin 1' contours. Section 24-66(b) of the Land Development Regulations requires on-site storage for increased runoff. Provide Delta volume calculations and on-site retention required ^ er Section 24-66(b). (See attached info. Sheet) If on-site storage is required, a post construction topographic survey documenting ^ ro er construction will be re uired. A Right-of--Way Permit must be obtained for use ^ A Revocable Encroachment Permit must be obtained. ^ Pool - Wellpoint (if used) must discharge into vegetated area 10' minimum from ^ street or drama e feature (swale, structure or la oon). All concrete driveway aprons must be 5 inches thick, 4000 psi, with fibermesh from the edge of the pavement to the property line. Reinforcing rods or mesh are not ^ allowed in the ROW (Commercial driveways - 6" thick). Any utility cuts in the road must be repaired using COJ Standard Detail Case X and must be overlaid 10 feet in each direction from the center of the cut. Repair must be ^ shown on the lans. P -Roll off container company must be on City approved list and cannot be placed on City right-of--way. ^ r a,~~~'(j CiTY OE A'fLANTi IC BEACH ~ ~ ~~ CONSTRUCTION PERMIT WITHIN CITY RIG SEMENTS .~, ,- . _ - ~ 800 5emino(e Road 904-247-5800 - ' ~x.~~ ~ :s~: !~~.tiSh~. Atlantic Beach, Florida 32233-5445 904-247-5845 PLEASE SUBMIT (3) COMPLETE SETS OF PLANS ViIITN APPLICATION. J~~ '~ 5 ZO1~ --, Date (~ ~! J/ /O BY_ , Job Address / U 7C) ©C-eC~, n ~L V 7 I """"" `°' "'~~°'"'"'~ Permitee: _ ~~o o ~ ~o ~ c~~~ Telephone ~ 90t/ ~S 7 4 7 3 ~ S Permiftee Address: ~ ©~ a a C e~ ~ ~ I y ci. Requesting Permission to Construct: __ L o w e ~. yr~ a ~ ~ ~ ~+ Sn C t.2..1,.Q 2 p ~ / ~ T!` i ©c c a r. Location: (Reference to Cross-Street) I 1 ~~ ~ d c- ea n 1. Applicant declares that prior to filing this application he has ascertained. the location of all existing utilities, both aerial and underground and the accurate locations are shown on the sketches. A Letter of Notification was mailed to the following Utilities/Municipalities: Jacksonville Electric Authority Yes ( ) No ( ) Date: Bell South Telephone Company Yes ( ) No ( ) Date: Ferrell Gas Yes ( ) No ( ) Date: Comcast Yes ( ) No ( ) Date: 2. Whenever necessary for the construction, repair, improvement, maintenance, safe and efficient operation, alteration or relocation of all, or any portion of said street or easement ~as determined by the Director of Public Works, any or all of said poles, wires, pipes, cables or other facilities and appurtenances authorized hereunder, shall be immediately removed from said street or easement or reset or relocated hereon as required by the Director of Public Works, and at the expense of the Permiftee unless reimbursement is authorized. 3. All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be performed under the supervision of ~ (Contractor's Project Superintendent) located at Telephone #: 4. All materials and equipment shall be subject to inspection by the Director of Public Works or his designee. 5. All city property shall be restored to its original condition as far as practical, in keeping with city specifications and the manner satisfactory to the city. 6. A sketch of plans covering details of this installation, as well as, a copy of a recent survey shall be made a part of this permit. Calculations showing any increase in lrnperviaus area on owne(r's lot or in the city Right of ~°ilav are to be included with this application. 7. This permittee shall commence actual construction in good faith with days. If the beginning date is more than 60 days from date of permit approval, then permiftee must review the permit with the Director of Public Works to make sure no changes have occurred in the area that would affect the permitted construction. 8. It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the City's right, title and interest in the land to be entered upon and used by the holder, and the Holder will, at all times, assume all risk of and indemnify, defend, and save harmless the City of Atlantic Beach from and against any and all loss, damage, and cost of expenses arising in any manner of the exercise or attempted exercises by the holder of the aforesaid rights and privileges. 9. The Director of Public Works shall be notified twenty-four (24) hours prior to starting work and again immediately upon completion. 0~4'NER Signed: Data: ~ ~ S io Before me da in the County of Duval, Slate O lorida, s'perso Notary blic a ar , St ~ , G u AM~1 My comm i ~ es: ''' :*~ ~'~ D Is£; r'^~ ~ DD 957760 Personally Known: ' °^' ~' .. Identification: .... ~ 4 ~~~ ~jr~~ ~cwA fE' bCa --'^"~- Gz"9 ~ s •~` rF ~' ~ ~~ S ~h~ h ~R ~~ ~h ~ ~ "-- / .~ 9F Rk -"` ~~ L- A ~~ ;, ~ _ ~:- e~1 rR1 ~$ ~ ~ ~ ~p ~~ ~.. V ~"~ ~ C~ ~ ~ s~ .Zly r~~ ~ n ~ to ny O~ V •' S1 p u ; ~ ~ °` ~~~ ,A $ ~~ I ~ ~ ~2.y' t~; ~, /~;~. ~3~,~~ 1~~ ~ . Mj ~ ~°7n r 5 ~tiZa:n :n ~..3 2 n ~ 7 a~a°~a .z ." ~s x :n~~':r~ ~~~b` ~ ~ ~ ~ N ;*3 Z.3 >.r~ ., .. x ~,, ~~ ;ri ~ o 7 ~ ~7N5~ ..J.J Z ~ rr«« y ~ ~ '~ ~ Y~++ (vim 7 ~~`~~ `) ~'~~~ :< ~. ~ y x ~~, -3 > p G ~ LI' '" ~c?r W ~ ~ N .-~ 7 :t 7 ~ °~.~`~~ ~ ~vz~'~ G f ~v2 O z ~+ =~ H ~ ~m '~ r ~ n v 9 -~j I mx~~ a ~~ O ;•' C q ~.'Dnsn ~ 9 ~ ^i3 ~'NKQ n ~~ O N V /~~ ~Z~°.z 0 ~ ~ 7 x ~ y_: d CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 Application Number 10-00000427 Date 6/11/10 Property Address 1070 OCEAN BLVD Application type description RESIDENTIAL ALTERATION Property Zoning TO BE UPDATED Application valuation 167500 ---------------------------------------------------------------------------- Application desc REMODEL KITCHEN/BATH,SIDING NO ADDL SQ FT ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ MOODY OWNER ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit PLUMBING PERMIT Additional desc . Permit Fee 195.00 Plan Check Fee .00 Issue Date Valuation 0 Expiration Date 12/08/10 ---------------------------------------------------------------------------- Special Notes and Comments *2007 FLORIDA BUILDING CODE W/'05-'06 SUPPLEMENTS. 2007 FLORIDA BUILDING CODE - RESIDENTIAL. 2005 NATIONAL ELECTRICAL CODE. *SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST CONTROL COMPANY PRIOR TO C.O. *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ------- Permit Fee Total Plan Check Total Grand Total 195.00 195.00 .00 .00 .00 .00 .00 .00 195.00 195.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION Jos ADDRESS: # ~--- NEW OR REPLACEMENT INSTALLATION: TYPE oFFIXTURE Bathtub Clothes Washer Dishwasher Drinking Fountain Floor Drain Floor Sink Hose Bibs Kitchen Sink Laundry Tray Lavatory Other Fixtures Qn i RE-PIPE: TYPE OF FIXTURE Bathtub Clothes Washer Dishwasher Drinking Fountain Floor Drain Floor Sink Hose Bibs Kitchen Sink Laundry Tray Lavatory Other Fixtures CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph (904) 247-5826 Fax (904) 247-5845 Septic Tank & Pit Shower Shower Pan Slop Sink Three Compartment Sink Toilet Urinal Vacuum Breakers Water Connected Appliances Water Heater Water Treating System QTY TYPE of FIXTURE Septic Tank & Pit Shower Shower Pan Slop Sink Three Compartment Sink Toilet Urinal Vacuum Breakers Water Connected Appliances _ Water Heater Water Treating System Q~ ~~ ~~ Q~ MISCELLANEOUS: ^ Sewer Replacement ^ Back Flow Preventer ^ Grease Interceptor (Trap) gallons (Requires 3 sets of plans) ^ Lawn Sprinkler System-Number of Heads ^ Well ** ~'~ SIRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.** ^ Other 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. Property Owners Name ~~ ~~ Phone Number Plumbing Company Co. Address: ~~ Or /~~d IIr License Holder (Print): Project Value ~ TYPE of FIXTURE _Off ce^P~hone 6~Fax~ ~~p~- City f~'~ ~ ~G ~ State ~ Zip ~ z ~~ State Certifcation/Registration # ~~~' 37~~~ 1'~ol`ft ' ~ ~. /O~ORAH A. E7~[~~'Y ~ r ~~~ ~` MY COMMISSION # DD 634126 Sworn and Scribed be rem day 20 ~~ '*` ' ` EXPIRES: May 21,2011 %~ .~` 3onded Thru Notary PubUc Undernr~e~ '~°~~" Signature of Notary Public CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 Application Number 10-00000427 Date 6/30/10 Property Address 1070 OCEAN BLVD Application type description RESIDENTIAL ALTERATION Property Zoning TO BE UPDATED Application valuation 167500 ---------------------------------------------------------------------------- Application desc REMODEL KITCHEN/BATH,SIDING NO ADDL SQ FT ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ MOODY OWNER ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit ELECTRICAL PERMIT Additional desc . Sub Contractor LIMBAUGH ELECTRICAL CONTRAC Permit Fee 90.00 Plan Check Fee .00 Issue Date Valuation 0 Expiration Date 12/27/10 ---------------------------------------------------------------------------- Special Notes and Comments *2007 FLORIDA BUILDING CODE W/'05-'06 SUPPLEMENTS. 2007 FLORIDA BUILDING CODE - RESIDENTIAL. 2005 NATIONAL ELECTRICAL CODE. *SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST CONTROL COMPANY PRIOR TO C.O. *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ------- Permit Fee Total Plan Check Total Grand Total 90.00 90.00 .00 .00 .00 .00 .00 .00 90.00 90.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ELECTRICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd, Atlantic Beach, FL 32233 P 4) 247-5826 F 904) 247-5845 Job ADDRESS' ~ /~ PERMIT # f ~li NEW SERVICE DOverhead [~ Underground ^ Underground up Pole ^Residential (Main). Service .i ^0-100 amps ^ 101-150amps ^ 151-200amps ^ amps # of Meters ^ Commercial (Main) Service ^0-100 amps ^ 101-ISOamps ^ 151-200amps ^ amps ^CT Service amps Conductor Type Size _ ^Multi-Family (Main) Service ^ 0-100 amps ^ 101-150amps ^ 151-200amps ^ amps # of Unit Meters ^Temporary Pole ^ amps SERVICE UPGRADE ^ amps ^ CT Service amps NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES~ETC.) ^ 100 amps ^ 150amps ^200amps ^ 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 ^ Swimming Pool ^ Sign ^ Smoke Detectors Qty ^ Transformers KVA ^ Motors hp FIRE ALARM SYSTEM (Requires 3 sets of plans & Fire Alarm Checklist) Qty volts/amps YAL UE OF WORE $ REPAIRS/NIIS CELLANEOUS OReplace urnt/Damaged ter Can ^Safety Inspection ^Panel Change ,~OH to UG ~O~elri.. ~~ `~ t ~ ~1~~C) M ~~ ~ ~~ ~ `~? ~' 2 ~12~n. R lwc~ .°~' li,~ SCE ~' ~ ~G~~ c~ Pern~it 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. Property Owners Name Phone Number O~ ~ - ~ - r 1 Electrical Company ~(p Y»~,t _ (~1, ~~.~Yi CG~ Zit Y~Y~, ~ done Z~~pl I-~G~ I Fax 2 ~-(GC~S1 O~ Co. Address: ~ 1 1(t°e City ~"~t~l'}~C 1-~'[,~ ~~ .License i•tier (Print): - (~ State Certification/Registratton # IYatarizec>' ~igrzc~tua~~ a~`'~Ee~rise ZIoPa°er v~" at429r~-t?uplic State of f=1 ~ a Swam and subsc 'bed be t :~ said t~~R~tty 20~ ~, ~ o~ ~ ~z Cmt11r1o13 Signature of Notary Public._ - -= ~ ~