705 BONITA RD - ERES20-0190 Electrical Permit Application **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department:(:' Ts.........' .:', -V ,: . ,GRAY IS REQUIRED.
,i � 800 Seminole Rd, Atlantic Beach, FL 32233 E tLS�C:-
GI90
'``' 'l' Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: REF?D-0a)b
JOB ADDRESS: 70S— . —) CT /?b PROJECT VALUE $ 2 Jz3°• `'
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JEA INFORMATION REQUIRED ON ALL PERMITS: 2 ccs AMPS 2"tc, VOLTS / PHASE
NEW SERVICE: ❑ Overhead ❑Underground ❑Underground up Pole
❑Residential (Main)Service:
❑0-100 amps o101-150amps ❑151-200amps ❑ amps #of Meters
❑Commercial (Main) Service:
❑0-100 amps _:101-150amps o151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
❑Multi-Family(Main)Service:
❑0-100 amps o101-150amps o151-200amps ❑ amps #of Unit Meters
1 TEMPORARY POLE: amps
SERVICE UPGRADE: amps ECT Service amps
Li NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
❑100 amps ❑150amps I- 200amps amps CT Service amps
I I ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 0-30amps 31-100am ps 101-200amps
Appliances: 0-30amps 31-100am ps 101-200am ps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS:
❑Swimming Pool nSign nSmoke Detectors (Qty) ❑Transformers KVA EMotors HP
1 FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
REPAIRS/MISCELLANEOUS:
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change EON to UG
Other: s9...2 v.J r ,2� 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 giv ut ority to violate the provisions of any other state or local law regulation construction or the performance of
construcNan.m dZr 5 Ce.'
Owner Name: (( Phone Number:
Electrical Company: ,5-- /.-i ii c4 ec2t e.4 'K Office Phone: (9c`) S-"I'4 -O T-35"-- Fax:
Co.Address: l Zv --6' � 4( ' zt 2 Sr City: )ham %' `t.t"-''/(. State: (=I-- Zip: 2 2C1/4
License Holder: (�/3,L Gtr 5' P-% - State Certification/Registration#: C 130 I ? s--7 e
Notarized Signature of License Holder
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The foregoing instrument was acknowledged before me this? Vday - awl - 21 • tate of Flori• ounty of
Signature of Notary Public IIP
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"YY'" TONI GfNDLESPERGER Aillr
i I Personally Known OR[ ] Produced Identification
•'• i MY COMMISSION# pe of Identification:
GG 353178
.''��'� EXPIRES:October 6,2023
Bonded Thru Notary Public Underwriters