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248 Levy Rd sign/elec 2013 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 13-00002251 Date 3/12/13 Property Address . . . . . . 248 LEVY RD Application type description SIGN PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 2000 ---------------------------------------------------------------------------- Application desc cabinet sign w/ elec ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ ROCK GARDEN ENTERPRISES, INC GENERAL SIGN SERVICE CORP 248 LEVY ROAD 1940 SPEARING ST ATLANTIC BEACH FL 322332614 JACKSONVILLE FL 32206 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc . . Permit Fee . . . . 90 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 9/08/13 ---------------------------------------------------------------------------- Special Notes and Comments Sign to be 51 from right-of-way per plan. 2010 FLORIDA BUILDING CODE, FLORIDA FIRE PREVENTION CODE 2008 NATIONAL ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 STATE ELEC DCA SURCHARGE 2 . 00 STATE ELEC DBPR SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 90 . 00 90 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 8 . 00 8 . 00 . 00 . 00 Grand Total 98 . 00 98 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 13-00002251 Date 3/12/13 Property Address . . . . . . 248 LEVY RD Application type description SIGN PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 2000 ---------------------------------------------------------------------------- Application desc cabinet sign w/ elec ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ ROCK GARDEN ENTERPRISES, INC GENERAL SIGN SERVICE CORP 248 LEVY ROAD 1940 SPEARING ST ATLANTIC BEACH FL 322332614 JACKSONVILLE FL 32206 ---------------------------------------------------------------------------- Permit . . . . . . SIGN PERMIT Additional desc . . Permit Fee . . . . 65 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 9/08/13 ---------------------------------------------------------------------------- Special Notes and Comments Sign to be 51 from right-of-way per plan. 2010 FLORIDA BUILDING CODE, FLORIDA FIRE PREVENTION CODE 2008 NATIONAL ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 STATE ELEC DCA SURCHARGE 2 . 00 STATE ELEC DBPR SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 65 . 00 65 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 8 . 00 8 . 00 . 00 . 00 Grand Total 73 . 00 73 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 k[F I:LE COM W Office(904) 247-5826 Fax (904) 247-5845 JobAddress: 9-Llg Ze,.,,, 1?oc--rj Permit Number: 0 Legal Description Floor Area of Sq.Ft. Parcel Sq.Ft Valuation of Work$ Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): Addition Alterati Repair Move Demolition pool/spa window/door ornmercial Residential Use of existing/proposed structure(s)(circle one): c�r c�Mio If an existing structure,is a fire sprinkler system installed? (Circle-6ne): Yes No N/A Floni da Product Approval 9 For multiple products use product approvil form Describe in detail the type of work to be performed- e_� r?e Ld i-n L Property Owner Information: Name: IZO(-k 6yc--Jer, Address: 9 9 city State F)zip 3 0�� E-Mail or Fax#(Optional) 409 ;L'41 '(04- 12a33 Phone 104 -aLil v11j6:, Contractor Information: CompanyName: &e,-,e_.,t 4;L4,1 1/0 1-r Quaff*g Agent: Address: i ,L4 t�, city � '�J State I--I Zip Office Phone ?Oq 1-355 `34-3— Job Site/Contact Number F&,e -96 8 -tyo 6 Fax# State Certification/Registration# I�C.->- -- C,>-i Architect Name&Phone# Engineer's Name&Phone iln Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address 4pplication is hereby made to obtain apemit to do the work and installations as indicated. 1certj&that no work or installation has commencedprior to the issuance ofa permit and that all work will bepedbrmed to meet the standards ofall laws regulating construction in thisjurisdiction. Thispermit becomes null and void ffwork is not commenced within six(6)months,or ifconstruction or work is suspended or abandonedfor a period qfsix�,6)months at any time after work is commenced. I understand that separate permits must be securedfor Electrical Work,Plumbing,Sigits, Wells,PooLv, urnaces,Boileis,Heaters, Tanks andAir Condhioners,etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. Ihere cer!ify that I have read and examt-ned this application and know the same to be true and correct. Allpravisions oflaws and ordinances goveming this Vwork will be complied with whether specyted herein or not. The g nting of a permit does not presume to give authority to violate or cancel the provi.si.ons ofany otherfederal,state, or local la,,�regulating construction rthe performance of construction. Signature of Owner Signature of Contractor Print Name Print Name Sworn to and subs Sworn to and si ibscrib"fore me this Day of A20 this Day of 20f3 Notary Public N—otary Publio ej N%- SYBIL E. VINSON L* MY CONMSSION#EE212690 EXPIRES:Augast 03,2016 ELECTRICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH OPN y FILE C 800 Seminole Rd, Atlantic Beach, FL 32233 Ph(904)247-5826 Fax(904) 247-5845 JOB ADDRESS: gd PERMIT# 3-- �Ij JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE VALUE OF WORK$ NEW SERVICE 0 Overhead Ej Underground Underground up Pole EIResidential(Main)Service 110-100 amps El 101-150amps El 151-200amps El amps of Meters LICommercial(Main)Service E10-100 amps El 10 1-I 50amps 0 151-200amps arnps 11 CT Servi*cc_amps Conductor Type_ Size DMufti-Family(Main)Service 110-100 amps E]101-150wnps El 151-200amps 0—arrips 4 of Unit Meters []Temporary Pole L1 amps SERVICE UPGRADE El .......amps F1 CT Service amps NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.) E1100amps 0150arnps 0200anips 0_____anips EICT Service amps ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC. Outlets/Switches: 0-30amps 31-100amps 101-200amps Appliances: 0-30amps 3 1-1 00amp s 10 1-200amps A/C Circuits: 0-60amps 61-100amps Heat Circuits: # circuits kw Number of Lighting Outlets, Including Fixtures: OTHER ELECTRICAL PROJECTS []SwimmingPool jKSign 0 Smoke Detectors_Qty ElTransformers KVA El Motors hp FIRE ALARM SYSTEM (Requires 3 sets of plans) Qty_volts/amps VALUE OF WORK$ REPAIRS/MISCELLANEOUS []Replace Burnt/Damaged Meter Can 11 Safbty Inspection []Panel Change 11 OH to UG J-o eKil< 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 (Xk"r'� 64W(tse-S -PhoneNumber Electrical Company Office Phone Fax-SSS—S&3-a, Co. Address: City StateF1 Zip-?=WXo-Z y License Holder(Print): ft-ok State Certification/Registration 7�6S—&0 Y 4-� Notarized Signature of License Holder this Sworn and subscribed day of -Mc-tc-" 2013 RSYBIL E. VINSON My COWAISSION#EE212690 F-01RES:August 03,2016 V FILE COPY LETTER OF AUTHORIZATION TO: CITY OF ATLANTIC BEACH BUILDING &ZONING DEPARTMENT 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 RE: LETTER OF AUTHORIZATION TO WHOM IT MAY CONCERN: THIS AUTHORIZES GENERAL SIGN SERVICE CORP. AS OUR LICENSED SIGN CONTRACTOR (OR AGENTS OR SUBCONTRACTORS) TO SECURE PERMITS, VARIANCES, AND PERFORM SIGN INSTALLATIONS, REMOVALS OR MAINTENANCE AT THE PROPERTY LOCATED AT: RPC GENERAL CONTRACTORS, INC.-248 LEVY ROAD-ATLANTIC BEACII-1, FL 32233 BY: STATE OF Title: -6��m lor- V,oe ?-)n- COUNTY OF__I)AJV/1 I T HE F(JRL(3U M ADA OF la�'Aji, 2013 By Vv)bi-)a, F" S �)evltnv (LfwsI&r1] W)A 0 F I , klt9A I MY71r*&4_ �ejDfld-&�- CORPORATION, ON BEHALF OF SAID CORPORATION, WHO DID NOT TAKE AN OATH AND WHO: V//IS PERSONALLY KNOWN TO ME. PRODUCED CURRENT FLORIDA DRIVER'S LICENSE AS IDENTIFICATION. A 11 A MELVA BATTIS-flC My COMMISSION#DD 887689 EXPIRES:may 7,2013 Bonded Thru Notary Public Underwriters NOTARY PUBLIC SEAL/ STAMP NAME OF NOTARY PRINTED- Melva Ea �hshl" 2012 NOTICE OF PROPOSED PROPERTY TAXES DO NOT PAY Duval County, Florida THIS IS NOT A BILL Legal Description: 18-34 38-2S-29E SEC H ATLANTIC BEACH LOTS 1 TO 4 BLK 239 Aft ROCK GARDEN ENTERPRISES INC F I L E C 248 LEVY RD ATLANTIC BEACH, FL 32233-2614 007564 2-2 RE No: 171069000OR Use: 4897 Dist: USD3 Prop. Address: 248 LEVY RD Taxing Authority Tax Information Prior(2011) Your Final Tax Rate Current(2012) Your Tax Rate and Taxes Your Tax Rate and Taxes Taxing Authority Taxable Value* and Taxes Taxable Value* This Year if NO Budget This Year if PROPOSED Last Year(2011) Change is Made Budget Change is Made COLUMN1 COLUMN 2 COLUMN 3 COLUMN 4 COLUMN 5 COLUMN 6 COLUMN 7 COLUMN 8 RATE TAXES RATE TAXES RATE TAXES County 471,400 6.7446 3,179.40 294,600 6.9443 2,045.79 6.7446 1,986.96 Public Schools: By State Law 471,400 5.3050 2,500.78 294,600 5.5523 1,635.71 5.3520 1,576.70 By Local Board 471,400 2.2480 1,059.71 294,600 2.3528 693.13 2.2480 662.26 FIL Inland Navigation Dist. 471,400 0.0345 16.26 294,600 0.0341 10.05 0.0345 10.16 Atlantic Beach 471,400 3.3285 1,569.05 294,600 3.4550 1,017.84 3.4550 1,017.84 Water Mgmt Dist. 471,400 0.3313 156.17 294,600 0.3437 101.25 0,3313 97,60 SJRWMD TOTAL AD VALOREM PROPERTY TAXES 8,481.371 5,503.77 5,351.52 Property Appraiser Value Information ASSESSED VALUE ASSESSED VALUE MARKET VALUE (Bef—&eWj-.) (80om Exe�pfi­� Applies to School Millage Applies to Non-School Millage PRIOR YEAR(2011) 471,400 471,400 471,400 CURRENT YEAR(2012) 294,600 294,600 294,600 If you feel the market value of the Applied Assessment Reduction Applies to Prior Amount(2011) Current Amount(2012) property is inaccurate or does not Save Our Homes or Portability Benefit All Taxes 0 0 reflect fair market value as of January - 1. 2012, or if you are entitled to an Agricultural Classification All Taxes 0 0 exemption or classification that is not reflected, please visit the Duval County Non-Homestead 10%Cap Benefit Non-School Taxes 0 0 Property Appraiser's Office at 231 E. Forsyth Street, Jacksonville, Florida Exemptions Applies to Prior Amount(2011) Current Amount(2012) 32202, call (904) 630-2011 or one of Charitable& Institutional All Taxes 0 0 the numbers on the back of this notice. First Homestead All Taxes 0 0 If the Property Appraiser's Office is unable to resolve the matter as to Additional Homestead Non-SchoolTaxes 0 0 the market value, classification or exemption, you may file a petition for Disability All Taxes 0 0 adjustment with the Duval County Value Adjustment Board. Petition Limited Income Senior County/Municipal 0 0 forms are available at the address Operating Taxes above or online at www.duvalpa.com. Wiclow/Widower All Taxes 0 0 Petitions must be filed on or before Historic Preservation County Operating 0 0 Taxes Deployed Servicemember All Taxes 0 0 September 18, 2012 SEE REVERSE SIDE FOR EXPLANATIONS OF THE COLUMNS AND SECTIONS ABOVE. > �j ;a (D 00 a * tA > -a > > r- G) >0 0 z zm 00% XZZ m m G) P m c -4 -4 < m z z m 3 3 ;a -- -< 0 Z 3 r- — M (-I m a 0 M C -in Z w m m:.3 go 0 C > mo > )j 0 = -0 C > > > r- o z --I r-, 0 n 0� IA fL < 0 g' - C) z r - 4 W m > .< M 0 r z X r- > ZC th 3 0 0 0 0 z > 0 <0 > -n ;o z 0 > > C > > 0 o im -4 m X tA -4zn — m .0 0 m m 4A * 0 to -- m -n m 03 0 z > :; Z Z all .r m m -4 Z M C 0 > 0 0 '-" G) 1> rr, IM m tA > r- 0 IM m 0 --4 -i ;o m m I m 1-< 1> tA m > LA C -n -V 10 r- To > m CD 10 is X I 1w Z C: L's 20 0 G) m CA -4 n to -L U -1 -4 C) 'U'v m m > 3.= 0 > z 4A <11 21 >., A C 0 m n mz " T z M cy 0 z,'m _4 > m MO I r's 4 3 xnx m -40 < m m ;000 Emm X m "05 :E3Z Z 0 2:E� Ch 0 p6 Z 0> n ,:!z 0 zal < 0 4 �121 — > z F I z m ol m n 0 0>1 -4 M, to ou w 0 0 —4 o 0 0 -wa'� ;a M -4 tA LA M lw oc,3 S,10,i�� �;0, o CD Zli 2-0 -0 io- S. 9� 10 CD 'P, CD 50 ol cr z 0 > r- T lzio, o p k Allo c m ;a A CD 0 x 0 x 0 m t Oc, -S :;, ii ') a r: V, a z o 10,-cl, cr L, 00 Q coo -4 5 0 WCD z m m - z CD CD 0) 0 C,.�,C, -0 7n, COD�r Co 0 (p CD 'CD C) co (P CD 0 0 0),t- C, , g(�,CD C, CD C) i-S LAilf City of Atlantic Beach VAR 0 Im 4. APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 00 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904 247-5826 - Fax(904)247-5845 it 1!9) E-mail: building-dept@coab.us Date routed: City web-site: http:/Avww.coab.us .1 - APPLICATION REVIEW AND TRACKING FORM Property Address; De ent review required Yes No ui Applicant: S' /V lanning &Zoni�� r istr -Tr-e-e--A-d—ministrator Project: C2 lef e_ Public Utilities J191V Public Safety Fire Services u Review fee $ Dept Signat'0­ - Other Agency Review or Permit Required Review or Date —-of Permit Verified By 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: APPLICATION STATUS Reviewing Department First Review- �Approved. nDenied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: TREE ADMIN. Second Review: DApproved as revised. nDeniJ ot PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: nApproved as revised. FIDenied. Comments: Reviewed by: Date: Revised 07/27110 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) SS 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us L__!Ite routed: City web-site: hftp://Www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address- D9par"ent review required Yes No < Bujiain� Applicant: _27 it A/ :::::--Planning &Zonin4 .-T-re-e-Ad—ministrator Project: C5�.07/V - ev & -,r5-u bi ic Wodkt;., Public Utilities Public Safety Fire Services ReView fee s, Dept Signature- Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By 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 Fother-- APPLICATION STATUS Reviewing Department First Review: [�J<proved. [-]Denied. (Circle one.) Comments: BU ±PL=ANNING &ZONING 43/A D Reviewed by: Y Date: 1201 TREE ADM IN. Second Review: F]Approved as revised. FIDenied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: F]Approved as revised. E]Denied. Comments: Reviewed by: Date: Revised 07/27/10 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road -5445 Atlantic Beach, Florida 32233 Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: City web-site: hftp://www.0O2b.us I APPLICATION REVIEW AND TRACKING FORM -L�l i Property Address: 67?�g DqpzdMent review required Yes,,Mo Build Applicant: C) /V ,�--Nanning &Zo2jpo 766-6-A-dm—i n istrato,r Project: c5:7 C2_'111 ',,:�15ublic Work_t> Public Utilities Public Safety 1v 19 Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date Florida Dept. of Environmental Protection of Permit Verified By 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 L Other: APPLICATION STATUS Reviewing Department First Review: Ep<pproved. [-]Denied. (Circle one.) Comments: PLANNING &ZONING Reviewed by: h71r�_ Date:5 3 TREE ADMIN. 11 7T Second Review: FlApproved as revised. Ej&nied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: [-]Approved as revised. E]Denied. Comments: Reviewed by: Date: Revised 07/27/10 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 Application N er . . . . . 13-00002394 Date 3/29/13 Property Address . . . . . . 248 LEVY RD Application type description ELECTRIC ONLY Property Zoninc. . . . . . . . TO BE UPDATED Application valuation . . . . 0 -------------------- -------------------------------------------------------- Application deEc addl work for sign -------------------- -------------------------------------------------------- Owner Contractor ------------------------ ---------------I--------- ROCK GARDEN EN .ERPRISES, INC LIMBAUGH ELECTRICAL CONTRAC 248 LEVY ROAD 42 WEST 8TH STREET ATLANTIC BEACH FL 322332614 ATLANTIC BEACH FL 32233 (904) 241-9051 -------------------- -------------------------------------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc . . Permit Fee 90 . 00 Plan Check Fee . 00 Issue Date Valuation . . . . 0 Expiration Date 9/25/13 ----------------------------------------------------------------------------- Other Fees . . . . . . . STATE ELEC DCA SURCHARGE 2 . 00 STATE ELEC DBPR SURCHARGE 2 . 00 ----------------------------------------------------------------------------- Fee summary Charged Paid Credited Due -------------- -- ---------- ---------- ---------- ---------- Permit Fee To:al 90 . 00 90 . 00 . 00 . 00 Plan Check To:al . 00 . 00 . 00 . 00 Other Fee Totil 4 . 00 4 . 00 . 00 . 00 Grand Total 94 . 00 94 . 00 . 00 . 00 PERMIT IS APPROVED ONLV IN ACCORDANCE WITH ALL CITV OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. 2012-11-29 08:07 BuiLding Dept. 247 5845 >> 904 2490703 P 1/1 ELECTRICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd,Atlantic Beach, FL 32233 Ph(904)247-5826 Fax(904)247-5845 JOB ADDREss: L=qi -)t j,—E CA—, YERMIT a JEA INFORMATION REQUIRF D ON ALL PERMITS ANTS VOLTS PHASE VALUE OF WORK S NEW SERVICE El Overhead F7 Underground Underground up Pole OResidential(Main)Service 00-100 amps 0101-150amps 1.115 1.200amps 1-1 amps 9 of Meters OCommercial(Main)Service 00-100 amps 0101-150amps 0 15 1-200amps F_____,ainps FICT Service amps Conductor Type Size FlMulti-Family(Main)Service 00-100 amps [1101-150=ps 0 151.200amps O—amps 9 of Unit Meters OTernporary Pole 0 Amps SERVICE UPGRADE D amps 0 CT Service amps NEW FEEDER(ADDITIONS,A CESSORY STRUCTURES,ETC.) 0100amps 0150amps L3200amps 0 amps OCT Service amps ADDITIONS,REMODELS,REPAXRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC. Outlets/Switclics: 0-30amps 31-1 00amps 101-200amps Appliances- 0-30amps 31-100amps 101-200amps A/C Circuits: Q-60amps 61-1 00amps Heat Circuits: � circuits @ kw Number of Lighting Outlets, Including Fixtures: OTHER ELECTRICAL PX0JECTS hp OSwimmingPool LYSign 1'.]Smoke Detectors_Qty D Transformers_KVA OMotors_ F M, ALARM SYSTEM (Requires 3 sets of plans) Qty volts/amps VAL U9.OF WORKS REPAIRS/MISCELLANEOUS 11 Replace Burnt/Damaged Mi-.ter Can 11 Safety inspection , F-TanelChange 0 OH to UG 00thcr: certify that I have Permit becomes void if work does not com,7ence TMithin a six month period or work is suspended or aband ned for six months. I hereby read this application and know the same to )c true and correct, All provisions of laws and ordinances governing this work will be complied with whether specified or noL 'ilia peffnit does not give authority to violate die provisions of any other slate or local law regulation construction or the performance of construction. Property Owners Name ct-f-0. Phone Number 2-1-4 1 P66 Phone Cq-2-44 Electrical Company ri-)V7!1 t A-) Co. Address: HL L-Q?Si4 -V Ilk) (,Pee city�Aitctnt�C- kip License Holder(Print) State Certification/Registration ®R V I MUM-W 4 Notarized Signatur -efv NO ry NCA y b 0 Bi'aa Fa! M f Commission D086878 ic E,pireftfiWfe of Not Public