838 OCEAN BLVD ERES20-0229 Electrical Permit Application **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building DepartmentOE.
GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 yes
" . ,, Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: ' 3c:5- (36:e cl ei .(PII'cl, PROJECT VALUE $ 4 OD
JEA INFORMATION REQUIRED ON ALL PERMITS: I7- AMPS <-290 VOLTS 1 PHASE
I I NEW SERVICE: ❑ Overhead ❑Underground oUnderground up Pole
❑Residential (Main)Service:
❑0-100 amps X101-150amps o151-200amps ❑ amps #of Meters
oCommercial (Main)Service:
❑0-100 amps o101-150amps o151-200amps ❑ amps ECT Service amps
Conductor Type Size
❑Multi-Family(Main)Service:
n0-100 amps nl0l-150amps o151-200amps in amps it of Unit Meters
TEMPORARY POLE: amps
n SERVICE UPGRADE: amps ICT Service amps
❑ NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
100 amps ❑150amps ❑200amps 1 amps nCT Service amps
I I ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS, ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 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:
❑ OTHER ELECTRICAL PROJECTS:
❑Swimming Pool Sign ❑Smoke Detectors (Qty) oTransformers KVA oMotors HP
n FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
1 REPAIRS/MISCELLANEOUS:
❑Replace Burnt/Damaged Meter Canr�S{afety Inspection ❑Panel Change ❑OH to UG
Other: i�,e p lac Q Y A G l� L1 re A, k.a_r 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 th ovisions of any other state or local law regulation construction or the performance of
construction 0 SO-etgo
,t 5/ I-1305 Owner Name: i Y('Q r"1 —` QC` Phone Number: ']
Electrical Company: t— q f
p y: rc%.�A, Office C ) C'�} . l' Office Phone: I D 9 (43 —8 sy?Fax:
Co.Address: cod >o 11 th P.k/ " l J 0't+V\ City: .�G,( i?',c h State: f`"L Zip: 3,32-5-C'
License Holder: Z-74-14-\0 SI /74-ty (1-1-1. State Certification/Registration#: rC /J ,2-era
Notarized Signature of License Holder' J 0 / /(-7 f
The foregoing instrument was acknowledged- fore me this-)day of 11:0,e_ _6 the St to of Florida,County of _
Signatuof Notary Public . 111PJ Li
i"�Y'�k;• TONI GINDLESPERGER
``, ype of Identification:
MY COMMISSION#GG 353178 [ ersonally Known OR[ 1 Produced Identification
'-:,=;:...<--:•\R•,;„-- EXPIRES:October 6,2023
1 '``''r;4,' Bonded Thru Notary Public Underwriters