2060 BEACH AVE Electric Permit Application ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845 i (�J -C(cc_ l z Sc�
JOB ADDRESS: 2 D (D "Ic 4 /fie
PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS Q v AMPS t VOLTS
l PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
❑Residential(Main) Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
❑Commercial(Main) Service
00-100 amps 0101-150amps 0151-200amps 0-amps
Conductor Type Size [I CT Service amps
❑Multi-Family(Main) Service
110-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
❑Temporary Pole [i-amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
%W FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps 0150amps 0200amps []_amps OCT 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:
,THER ELECTRICAL PROJECTS
11 Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motors hp
IRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
EPAIRS/MISCELLANEOUS
❑Replace Burnt/Da/maged Meter Can []Safety Inspection ❑Panel Change 11 OH to UG
El Other:-- lr C c Yt2Y -'�` rr'
mit Tomes 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
I 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
-ified or not. The pen-nit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of
struction.
perty Owners Name �14S5cd- Phone Number Z,
ctrical Company �f fi0 ' �'�cc>< Office Phone 71-,L/- 2Fax yo�-Z y/ -F03
Address: ry/,i,,� �, .�� R 1 City /U 143 State Zip 3
nse Holder (Print): 6jn zf State Certification/Registration# F 13 'X
'ar'ized Si,&h'4h9rPPrIlolder J001 RICHMOND
BANK O AM ':may
NEPTUNE BEACH,FL 32266-51�efore me is ( �� ON MFF 977570
FOR DEPOSIT ONLY da f 0 EXPIRES:March 31,2020
CRAWFORD ELECTRICAL 's^, Bonded Thru Notary Pubic Under*"
898065244822 Signature of Notary Pub '