359 Sherry Dr ERES20-0227 App Electrical Permit Application **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:EItts-ZQ-
JOB ADDRESS: rzCL-t1b ti . PROJECT VALUE $ 32-Z/z7•4"-`)
JEA INFORMATION REQUIRED ON ALL PERMITS: ?o AMPS l2'ziyc VOLTS ] PHASE
NEW SERVICE: a Overhead ❑Underground uUnderground up Pole
;Residential (Main)Service:
❑0-100 amps n101-150amps o151-200amps ❑ amps #of Meters
ricommercial (Main)Service:
❑0-100 amps D101-150amps o151-200amps ❑ amps DCT Service amps
Conductor Type Size
❑Multi-Family(Main) Service:
❑O-100 amps 101-150amps D151-200amps ❑ amps #of Unit Meters
I TEMPORARY POLE: amps
SERVICE UPGRADE: ❑ amps DCT Service amps
NEW FEEDER (ADDITIONS,ACCESSORY STRUCTURES, ETC.):
100 amps ❑150amps ri200amps amps DCT Service amps
ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS, ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 10 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: I L
OTHER ELECTRICAL PROJECTS:
Swimming Pool ,;Sign iSmoke Detectors (Qty) ❑Transformers KVA ❑Motors HP
FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
REPAIRS/MISCELLANEOUS:
;Replace Burnt/Damaged Meter Can L-]Safety Inspection ❑Panel Change DOH to UG
❑Other: 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.
Owner Name: IiArc..bActn oPhone Number: 9o`f-�y�' J' �78
Electrical Company: l,,J i2_2szn-t• Ciac n-. Office Phone: 0101 1 `{ ?ref' Fax:
Co.Address: inn) 1 Wv - City: /-i kSC-.?'tt& State: t"L Zip: 3 -?-2
License Holder: Mrgrt.ti �( State Certification/Registration#: CC i so 5(c 9
Notarized Signature of License Holder t \o._.� f\•
The foregoing instrument was ackno. -dged before me this:.—....) day c� 111 tol 21 n the S • - o F orida,County of
T #GO
Signature of Notary Public •
111,
„ MY COMMISSION#GG 202376
*te 14 a+: Ex RES:October 6, [ ] Personally Known OR Produced Identification
'�rFpp�,o`:� Bonded Thru Notary Public Undervrtiters Type of Identification: