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2233 Seminole Rd Unit 25 ERES21-0180 App = Electrical Permit Application **ALL INFORMATION HIGHLIGHTED IN City of Atlantic Beach Building Department GRAY IS REQUIRED. j1 . 800 Seminole Rd, Atlantic Beach, FL 32233 Phone: (904) 247-5826 Email: B ilding-Dept@coab.us PERMIT#: JOB ADDRESS: 1233 SOY\ ►Yi.0 C- - �c,f on' i Z. PROJECT VALUE $ 3000 - JEA INFORMATION REQUIRED ON ALL PERMITS: )cC�AMPS'Z46UVOLTS I ' PHASE D NEW SERVICE: ❑Overhead OUnderground ['Underground up Pole Otesidential (Main)Service: 00-100 amps D101-150amps 1:1151-200amps ❑ 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: 00-100 amps 0101-150amps 10151-200amps 0 amps #of Unit Meters 11 TEMPORARY POLE:- amps E SERVICE UPGRADE: 0 amps OCT Service amps I1 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: 0-30amps 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) ❑transformers KVA ['Motors HP H FIRE ALARM SYSTEM (Requires 3 sets of plans): Qty volts/amps N.REPAIRS/MISCELLANEOUS: DReplace B rnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change DOH to UG [Other: �� 1 S—-A — 7 0 pc 17G V C iv' i--go M /141_ '�© C-i 1 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 1 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 folate the provisions of any other state or local law regulation construction or the performance of construction. Owner Name: ( �( Phone Number: � V� � •i (C `^ one: O � E © x: Electrical Company: ] � �j LGL— R 1 p ((�� L{ 1 1 f+� 4 c� _ Co.Address: ( 0 t , 7 Q 1-Q 5 IT RU-v 5) Pc RO city: ,)'7V'\ T �J 1 tstate:( Zip:522c7--- License �� License Holder: _ Ake I, I 'rk4te Certification/Registration#:I jt n) I (-1 Notarized Signature of License Holder The foregoing instrument was acknowledged before me this 27 day of ) J L1 ,20'7/, in the State of Florida,, County of Q U V/}L. •••'i"' , CHRISTIAN I Signature of Notary Public . VZity i'1__ ,/4//(/Lk. ,.: ?• * MY COMMISSION#HHS 117153 [ ] Personally Known OR[1roduced Identification ' ';;o, EXPIRES:April 13,2025 Type of Identification: r r .,!..-'�• L wL L . Bonded Tlru Notary Public UnderwrNera