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845 PLAZA = ELECTRIC ,i rly�jet, CITY OF ATLANTIC BEACH Jy u¢� gl ( ,? 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 rm INSPECTION PHONELINE,247-5814 ELECTRICAL RESIDENTIAL - MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: ERES17-0208 Description: 200 amps/240 volts/single-phase- 15 outlets, 10 fixtures Estimated Value: 1800 Issue Date: 12/7/2017 Expiration Date: 6/5/2018 PROPERTY ADDRESS: Address: 845 PLAZA RE Number: 171111 0000 PROPERTY OWNER: Name: BOURGEOIS MICHAEL R LIFE ESTATE Address: C/O ALFRED L BOURGEOIS16117 SHELLCRACKER RD JACKSONVILLE, FL 32226 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: SEASIDE ELECTRICAL CONTRACTORS Address: 12381 APPLE LEAF DR QA CLARK GEISSMAN JACKSONVILLE, FL 32224 Phone: PERMIT INFORMATION: Please see attached conditions of approval. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. * A notice of Commencement is only required for work exceeding an estimated value of $2,500. For HVAC work, a Notice of Commencement is only required when HVAC work exceeds and estimated value of$7,500. ELECTRICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd,Atlantic Beach, FL 32233 ©a Ph(904) 247-5826 Fax (904) 247-5845 6€ S1 — JOB ADDRESS: 7 PLf Z A- /2.0, PERMIT# A I.7 - 00/6 JEA INFORMATION REQUIRED ON ALL PERMITS Z-0 AMPS 210 VOLTS / PHASE VALUE OF WORK$ '6:)L7. NEW SERVICE ❑ Overhead n Underground J Underground up Pole ❑Residential (Main) Service 00-100 amps ❑101-150amps ❑151-200amps ❑ amps # of'Meters ❑Commercial(Main) Service 00-100 amps ❑101-150amps ❑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 0200amps ❑ amps OCT Service amps ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC. Outlets/Switches: i'.g"- 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: /4.3 OTHER ELECTRICAL PROJECTS ❑Swimming Pool ❑ Sign ❑Smoke Detectors Qty ❑Transformers KVA ❑Motors hp FIRE ALARM SYSTEM (Requires 3 sets of plans) Qty volts/amps VALUE OF WORK$ REPAIRS/MISCELLANEOUS ❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG ❑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 /--//)-A) I /( L /717+121— Phone Number Electrical Company �� Klech( • Office Phone 5 l (-(-c4-3<- Fax Co. Address: /2 1-26-3 l eAwit-� OA, .7=1-2.3S City )Jf P—J.`f L State 1a Zip 72?La License Holder (Print): (z vIC C��S� T�/(�/ State Certification/Registration#& (5ô 1 35-1 N¢i ;figE:.orgartise gi lder 11/R.--k--z MY COMMISSION#GG 0429:4 ;y EXPIRES:October.27,2020 :Sworn and subscribed before me thi, day of p Q..U('{1 20 19" '• Pubic tJ dzM�riters +t 6ondedThruNotaryP _ Signature of Notary Public �l . `•