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475 PALMWOOD LN - TEMP20-0006 '' > ,,., Electrical Permit Application **ALL INFORMATION -47� tCity of Atlantic Beach Building Department GRAY IS REQUIRED.. 800 Seminole Rd, Atlantic Beach, FL 32233 C� i \. ) Z.0 ` v�o(e• `--—'�� HIGHLIGHTED fN Phone: (904) 47-5826 Email: Building-Dept@coab.us �Q �/...r PERMIT#:go JOB ADDRESS: /7� f11 � PROJECT VALUE$ -, 1)6): IEA INFORMATION REQUIRED ON ALL PERMITS:_ C.) AMPS__Z.(:-VOLTS / PHASE ENEW SERVICE: 0 Overhead ❑Underground ❑Underground up Pole Residential(Main)Service: 00-100 amps Q101-150amps 0151-200amps 0 amps #of Meters ❑Commercial(Main)Service: 00-100 amps 0101-150amps D151-200amps 0 amps Conductor Type Size P OCT Service amps ©Multi-Family(Main)Service: ❑0-100 amps 1:3101-150amps 0151-200amps 0 amps #of Unit Meters 1— TEMPORARY POLE: i10 amps I I SERVICE UPGRADE: ❑ amps Du Service amps NEW FEEDER (ADDITIONS,ACCESSORY STRUCTURES, ETC.): 0100 amps 0150amps 0200amps 0 amps l3T Service amps 1 I ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC: Outlets/Switches: 0-30amps 31-100ams ___ p 101-200amps Appliances: 0-30am ps 31-100amps _101-200ams A/C Circuits: 0-60amps 61-100amps P 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 I I REPAIRS/MISCELLANEOUS: ❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change DOH to UG lather: Updated 10/17/18 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. J Owner Name: �►- _ Phone Number: 9(,.5i_ "1:41g.:::1011/ Electrical Company:ALLSTATE ELECTRICAL CONTRACTORS,INC ' Office Phone: 904-29S-2700Fa X:904-296-3471 Co.Address: 7447 SALISBURY RD JACKSONVILLE City: State: FL Zip: 32256 License Holder: JAMES L. WILLIAMS State Certification/Registration#: EC-000113 Notarized Signature of License Holder �el'Ate, 1e. —e40-0Tiri� ��'/f 3 The foregoing instrument was acknowledged before me this /312—day oft ,20 Z in the State of Florida, County of bu(Jai Signature of NotaryPublic ,��1 l t� �_IRI3.melse ( ersonall Known OR * t..,s * Commission#GG305213 Y [ J Produced Identification 0:,., . Type of Identification: >, ..z.(0* Expires June 1,2023