1230 OCEAN BLVD ERES21-0124 �.t Electrical Permit Application **ALL INFORMATION
`.,•S r,,: HIGHLIGHTED IN
r 1!! City of Atlantic Beach Building Department GRAY IS REQUIRED.
Arr 800 Seminole Rd, Atlantic Beach, FL 32233
' _'/ EI.R S Z_ t- 0( Z
"�"'` Phone: (904) 247-5826 Email: ..iiiull_ LJupt coab.us PERMIT#:
JOB ADDRESS: 1230 OCEAN BLVD PROJECT VALUE $$ 6,450.00
JEA INFORMATION REQUIRED ON ALL PERMITS: 200 AMPS 120 VOLTS 1 PHASE
ElNEW SERVICE: 0 Overhead ❑Underground ❑Underground up Pole
Residential(Main)Service:
00-100 amps [3101-150amps 0151-200amps 0 amps #of Meters
❑Commercial (Main) Service:
❑0-100 amps 0101-150amps 0151-200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main) Service:
❑O-100 amps 0101-150amps 0151-200amps 0 amps #of Unit Meters
TEMPORARY POLE: amps
0 SERVICE UPGRADE: 0 amps OCT Service amps
Il NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
0100 amps 0150amps 0200amps 0 amps DCT Service amps
❑ ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 0-30amps 31-100a mps 101-200amps
Appliances: 0-3oamps 31-100amps 101-200amps
A/C Circuits: 0-6oamps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
r7 OTHER ELECTRICAL PROJECTS:
❑Swimming Pool DSign ❑Smoke Detectors (Qty) ❑Transformers KVA ['Motors HP
FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
n REPAIRS/MISCELLANEOUS:
['Replace Burnt/Damaged Meter Can ['Safety Inspection Eanel Change ❑OH 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: MICHAEL LINCOLN Phone Number: (904)535-8798
Electrical Company: PHASE 0 NE ELECTRIC, LLC Office Phone: (904)232-8263 Fax:
Co.Address: 2036 MAYPORT ROAD City: JAX State: FL Zip: 32233
License Holder: MICHAEL LINCOLN State Certification/Registration#: EC#1003588
Notarized Signature of License Holder
T fo tst14#t v edged before me this Z -day of A 207 in th State of Florida,County of
,YF.o , 'ONl GINDLESPERGER
MY COMMISSION#GG 353173 Signature of Notary PublicIV," — '
`.I--7:- .,,,--k.' EXPIRES:October 6,2023 • i
o:F�° funded Thru Notary Public Underwriters
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