645 Atlantic Blvd ERES18-0295 ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233 ��CC
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``Ph(904)2j47-5826 Fax (904)247-5845 E
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PERMITWk #
INFORMATION REQUIREDO TS
VALUE OF WORE$
NEW SERVICE ❑ Overhead ❑ Underground DUnder
❑Residential(Main)Service ground up Pole
00-100 amps 0101-150amps 0151-200amps ❑
❑Commercial(Main)Service amps #of Meters
00-100 amps 0101-150amps 0151-200amp s ❑
Conductor Type size amps ❑CT Service_amps
OMulti-Family(Main)Service
00-100 amps 0101-150amps 0151-200amps ❑
❑Temporary pole 0 amps amps #of Unit Meters
SERVICE UPGRADE 0_amps ❑ CT Service_amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100 amps ❑150amps 0200amps ❑ amps OCT Service_amps
4DDMONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30am s
Appliances: 0-30am s 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100ampa 101-200amps
Heat Circuits: #circuits @ law
Number of Lighting Outlets, Including Fixtures:
)THER ELECTRICAL PROJECTS .
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Tmndbrmers KVA ❑Motors_hp
IRE ALARM SYSTEM (Requires 3 sets of plans)
Qty_volts/amps
VALUE OF WORKS
EPADLS/11•HSCELLANEOUS
OReplace Bum/Damaged Meter Can ❑Safety Inspection OPanel Change OH to UG
❑Other:
nnit becomes void it work does not commence within a nix month period or work is suspended or abandoned for six montlu. I hereby certify that I have
d this application and know the same m be true and correct. All provisions of laws and ordinances governing this work will be complied with whether
:ctfiedon. Thepennit does not give authority m violate the provisions of my other state or local law regulation construction or the perfomumce of
tswction. A ,,,^ m
)PertY Owners Name WLR', I 'IQI 11.W N.1,� Phone Number
:ctrical Company C,Office Phon�-2��! Faxo37
.Address: {.t7 City�i .State Zip 4�
Wi°laer(paint): State Certification/Registration# r:�Q?407I-I{q
tariaed Si r
TONI GINDIESPEflGEfl
MY COM1IMISSIONaFF 924951E reme this
a' p EXPIRES'.October6.2619 ��'�
' Nand' BOMef mry No:ary Pueik UMercna .
tare of NotaryPublic
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Y CITY OF ATLANTIC BEACH
T 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
ELECTRICAL RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ERES18-0295
Description: OVER HEAD TO UNDERGROUND
Estimated value: 1000
Issue Date: 9/7/2018
Expiration Date: 3/6/2019
PROPERTY ADDRESS:
Address: 645 ATLANTIC BLVD
RE Number: 170662 0000
PROPERTY OWNER:
Name: 645 ATLANTIC HOLDINGS LLC
Address: 619 ATLANTIC BLVD
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: CRAWFORD ELECTRIC
Address: 2301 Marsh Point Road
Neptune Beach, FL 32266
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.
NOTICE: In addition to the requirements of this permit,there may be additional restrictions
applicable to this property that may be found in the public records of this county, and there may
be additional permits required from other governmental entities such as water management
districts,state agencies, or federal agencies.
* 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
IP Ph(904)247-5826 Fax (904)247-5845
VSsADnREss ( .� a&c n d32ZJ�
-PERMIT#
JEA INFORMATION REQUIRED ON ALL VOLTS
VALUE OF WORKS-,
NEW SERVICE ❑ Overhead ❑ Underground ❑J Underground up Pole
❑Residential(Main)Service
00-100 amps 3101-150amps 0151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
00-100 amps 0101-150amps 0151-200amps ❑
Conductor Type Size amps 0 C Service amps
❑Multi-Family(Mom)Service
00-100 amps ❑101-150amps ❑151-200amps ❑
❑Temporary pole ❑ _ amps amps #of Unit Meters
SERVICE UPGRADE 0-----amps ❑ CI Service_amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps ❑ amps ❑CT Service_amps
1DDITIONS,REMODELS,REPAIRS,BU LD-OUTS,ACCESSORY STRUCTURES,ETC.
OutleWSwitches: 0-30amps 31-100amps 101-200am s
Appliances: 0-30amps 31-100amps 101-200amp
A/C Circuits: 0-60amps 61-100amps s
Heat Circuits: #circuits @ kw
Number of Lighting Outlets, Including Fixtures:
)THEA ELECTRICAL PROJECTS .
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motors_hp
IRE ALARM SYSTEM (Requires 3 sets of plans)
Qty_volts/amps VALUE OF WORK s
EPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change AIH to UG
OOther:
rani[biomes 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
,it this application and know the same to be true and correct. All provisions of laws and ordinances governing this work%ill be com lied with whether
,cified or not The permit does not give authority to violate the provisions of any other state w local law regulation construction or the performance of
tstmction.
3perty Owners Name�-q.LA I 1 I( .Y AA.V\ Phone Number -d
:ctrical Company C,Office Phon�-2� ! FaxR�"�7
.Address: City�State Zip=241,
&Tinder(Print): State Certification/Registration# 15C 71�q
i `x', WCOMMISSSIONAEFFF92pM1
.. B remethis_7da
—
NI
». EXPIPEa:Odobat 6,2019
true of Notary Public