500 Clipper Ship Ln ERES21-0165 App ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: 600 C. peer ‘1p L2iM o I tP vl( FL- PERMIT#
1
32-233
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS .2 40 VOLTS i PHASE
VALUE OF WORKS t-i-gt —
NEW SERVICE ❑ Overhead ❑ Underground (l1 Underground up Pole
:Residential(Main)Service
00-100 amps 0101-150amps 0151-200amps 0 amps #of Meters
°Cotnmercial(Main)Service
00-100 amps ❑101-150amps ❑151-200amps 0 amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps 0101-150amps 0151-200amps 0 amps #of Unit Meters
:Temporary Pole 0 amps
SERVICE UPGRADE 0 amps 0 CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100»mps O 150amps O200amps 0 amps OCf Service amps
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 0 Sign :Smoke Detectors Qty :Transformers KVA ❑Motors __hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK S
REPAIRS/MISCELLANEOUS
°Replace Burnt/Damaged Meter Can ❑Safety Inspection1 ❑Panel Change OOH to UG
,Other: ?Lt-0 Vo l T- �1Q(l pump G f c(,u 1
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 he 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.
Property Owners Name Phone Number
Electrical Company (-e C/+ C ' 1.1.s__, _Office Phone 'f 3 y. Q Fax
Co.Address: j(i q Q LQ k e Sic, ' r City Sax State\ Zip 3 a25"-7
License!folder(Print): ". _ tate Cer ification/Registration# j3o I6 3
a 9
Not . ,, lder �7
..0.0:b' rlotary Pubic State o1 Florida
:.Iy1' . limey L Graham a3efore me this day off`!
?•, ,I ti',C umm a,.on FF 099990
�o.r.d' F..uire.02/rv2019
Signature of Notary Put :c