1 FLEET LANDING - COLEMAN CENTER ELPP20-0044 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#: GLP P 004
JOB ADDRESS: 1 Fleet Landing Blvd PROJECT VALUE $S-39;CC ( Coo
JEA INFORMATION REQUIRED ON ALL PERMITS: 1 0 0 0 AMPS Q17 VOLTS -.3 PHASE
• NEW SERVICE: 0 Overhead ❑Underground ❑Underground up Pole
E tesidential(Main)Service:
00-100 amps D101-150amps 1:3151-200amps ❑ amps #of Meters
❑Commercial (Main)Service:
❑0-100 amps 0101-150amps 0151-200amps ❑ amps OCT Service amps
Conductor Type_ Size
❑Multi-Family(Main) Service:
00-100 amps 0101-150amps 0151-200amps ❑ amps #of Unit Meters
n TEMPORARY POLE: amps
LI SERVICE UPGRADE: ❑ amps OCT Service amps
n NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
0100 amps 0150amps 0200amps 0 amps OCT Service amps
• ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 11 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 1 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures: 48
• OTHER ELECTRICAL PROJECTS:
❑Swimming Pool OSign ❑Smoke Detectors (Qty) ❑Transformers KVA ['Motors HP
n FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
n REPAIRS/MISCELLANEOUS:
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change DOH to UG
tether: 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: Naval Continuing Care Retirement Foundation Phone Number: (904)246-9900
Electrical Company: United Electric Co of Jacksonville Office Phone: (904)731-4210 Fax:(904)731-5311
Co.Address: 5716 St Augustine Rd Jacksonville FL 32207
City: State: Zip:
License Holder: DOUglaS W Derousie �/ /� State Certification/Registration It: EC13008083
Notarized Signature of License Holder
J.,
The foregoing instrument was acknowledged be ore me this c75�l2 day of Sy°/`^"E `Ce,20Zo in he St e of Florida, County of D,),/-/
Signature of Notary Public / !,-. K
"`��,'�°** BRENDA K. GRIFFIN
'°� MY COMMISSION#GG193986 [ rsonally Known OR [ I Produced Identification
oFF�c, EXPIRES April 23,2022 Type of Identification: