811 PARADISE LN TEMP21-0017 4,,, Electrical Permit Application **ALL INFORMATION
fy �� HIGHLIGHTED IN
47 01`..0004
City of Atlantic Beach BuildingDe artment _ AY IS REQUIRED.
' 800 Seminole Rd, Atlantic Beach, FL 32233 i ---p)es 1 - 00-77
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: O ) I Ry c I.Sc 1�An.y PROJECT VALUE$ °*.-?
JEA INFORMATION REQUIRED ON ALL PERMITS: AMPS VOLTS PHASE
El NEW SERVICE: 0 Overhead DUnderground ['Underground up Pole
C tesidential(Main)Service:
00-100 amps 0101-150amps 0151-200amps 0 _amps #of Meters
®Commercial (Main)Service:
00-100 amps 0101-150amps 0151-200amps 0 amps OCT Service amps
Conductor Type_ Size
Multi-Family(Main)Service:
CD-100 amps 0101-150amps 13151-200amps 0 amps #of Unit Meters
.0 TEMPORARY POLE: amps
LI SERVICE UPGRADE: ❑ amps OCT Service amps
❑ 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: 0-30a m ps 31-100amps 101-200a mps
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) ['Transformers KVA ❑Motors HP
❑ FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
❑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. Th permit does not give authorit to violate the provisions of any other state or local law regulation construction or the performance of
construction.
OwnernerName: IY1(
Q 1a �\ `3Q� Phone Number:
O 'rt-F �
Electrical Company: CMIrC\ .I jCA.� 0sy1A Office Phone:CP (( 3'3 Fax:q-1`f-AL3" "04
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Co.Address: ' I lr-4ti k ick City c-S:y-„,i t(Y State: Zip: 533 /
License Holder: ii. a. c,,,A _ C. ,t L. S Ce ific tion/Registration#: a-4 `3 Z ]
e".
Notarized Signature of License Holder I. 1
a•. `=- - -•• •ged befe e me this-1 day of Ju^4 ,20�) in the State of Florida,County of vtk
<„,.eygc, - BONNEL!.W.CRAIG � (� 1
i �4 1.-1 MYCOMMISc:ION#GG 248197 Signature of Notary Public L...6?�-�.-'l._�s�o L�
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;`�. ,c EXPIRES:Gsceml;ar 11,2022
••f. f3 Bonded ThruNot:1_yPublic Underwriters )4 Personally Known OR[ ] Produced Identification
Type of Identification: