1076 HIBISCUS ST APP aiuuv♦1\L\.AL 1 Ll�ltll l AI I L1l,Hl 1V1V
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233 _
�-t Ph (904) 247-5826 Fax(904) 247-5845 U UWD
JOB ADDRESS: I ( � 1 Sc - S PERMIT #
JEA INFORMATION REQUIRED ON ALL PERMITS 00 AMPS X40 VOLTS PHASE
VAL UE OF WORKS 900 - "00 - "
NEW SERVICE ❑ Overhead ❑ Underground ❑1 Underground up Pole
Residential(Main)Service
0-100 amps 101-150amps 151-200amps amps #of Meters
Commercial(Main)Service
0-100 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.) O �
100 amps 150amps 200amps amps CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-I00amps 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)
Qty volts/amps VAL UE OF WORK S
REPAIRS/MISCELLANEOUS
Replace Burnt/Damaged Meter Can Safety Inspection Panel Change OH to UG
Other
riod or work is suspended or abandoned for six months. I hereby certify that I have
Permit becomes void if work docs not commence within a six month pe
read this application and know the same to be true and correct. All provisions of laws and ordinances goveming 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 perforrnancc of
construction.
P �-���� N ctn o�S
Property Owners Name � Phone Number
Electrical Company 6,0 P�1 CA� �����< < _Office Phone 90`4-7/G-`I� cf Fax�C'943I 3cs,?
Co.Address: S793 City �, ,,,� SoAu,flC Statef�– Zip �ZZzY—
License Holder(Print): e� L s cLl ication/Registration#dbm'Ift
,i�P Pis ANGELICA:UEL1;
Notary Public Flotld1 My Comm.Ex25,2017 11129commissi