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Permit Well 1940 Sevilla W 2011 CITY OF ATLANTIC BEACH S 800 SEMINOLE ROAD `r ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 Application Number 11- 00002809 Date 10/21/11 Property Address 1940 W SEVILLA BLVD Application type description ELECTRIC ONLY Property Zoning TO BE UPDATED Application valuation . . . 0 Application desc pool circuit Owner Contractor HILLEGGS LIMBAUGH ELECTRICAL CONTRAC 42 WEST 8TH STREET ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 241 -9051 Permit ELECTRICAL PERMIT Additional desc . Permit Fee . . . 55.60 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 4/18/12 Other Fees STATE ELEC DCA SURCHARGE 2.00 STATE ELEC DBPR SURCHARGE 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 55.60 55.60 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 59.60 59.60 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ELECTRICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd, Atlantic Beach, FL 32233 F5--(-904) 247 -5826 Fax 9 4) 247 -5845 JOB ADDRESS: ' 1 C H40 � } -L,( 6_2- �4 PERMIT # JEA INFORMATION REQUIRED ON ALL PERMITS 9_AMPg g VOLTS , ( PHASE VALUE OF WORK $ NEW SERVICE ❑ Overhead ❑ Underground ❑1 Underground up Pole ❑Residential (Main) Service 00 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Meters CI Commercial (Main) Service 00 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps OCT Service amps Conductor Type Size ❑ Multi- Family (Main) Service ❑ 0 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Unit Meters ❑Temporary Pole ❑ amps SERVICE UPGRADE ❑ amps ❑ CT Service amps NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.) ❑ 100 amps ❑ 150amps 0200amps ❑ amps OCT Service a ( 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 FIRE ALARM SYSTEM (Requires 3 sets of plans & Fire Alarm Checklist) Qty volts/amps VALUE OF WORK $ REPAIRS/NIISCELLANEOUS - ___ ❑Replace Burnt/Damaged Meter Can ❑ Safety Inspection ❑Panel Change ❑OH to UG Other: /w / i L / . A iv_ Permit becomes void if work does not commence wit in 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. Property Owners Name M I • K H 1 ( l f' 1 s Phone Number ' 1 —' 1 32 Electrical Compan)LI rr .- ia L k J EE P(t - (ca.,t C b + rCtCar9ffice Phone c,2 - Ca Fax Co. Address: `3 7 .l JCS f � Q V E City } l tC &ate Fl Zip 32233 License Holder (Print): • Al∎ • State Certification/Registration # �� n! EC1300?7Y6 Notarized Signature of 1 e se o[ ed ' '- `11 �i�� �!i 4 b3 ta ry utlhc ct, 0 0 . K Kennelly JY • M�setcal ri• - ; •efo ..-_ this / y o , (*( '\ 201 1 N or f, .A expires 03/11 /2013 °� • . . . , -. ublic C JCUA Cti CITY OF ATLANTIC BEACH " 800 SEMINOLE ROAD � ATLANTIC BEACH FL 32233 O INSPECTION PHONE LINE 247 -5814 Application Number Property Address . . ' ' 11- 0 0002760 1940 W SEVILLA BLVD Date 10/17/11 Application type description WELL PERMIT Property Zoning - Application valuation TO BE UPDATED 0 Application desc ____________________ ____ __ NEW WELL --------------- - - - - -- Owner ---------------------- ------------ --- ____ ______________ Contractor HILLEGGS - - - -__ _ _ WILLIAMS WELL DRILLING INC P. O. BOX 330567 ATLANTIC BEACH FL 32233 ATLANTIC BEACH ____ ________ __ _ _ __ _ (904) 241 -8489 FL 32233 Permit -. . -,- -WELL PERMIT------------------- - - - - -- Additional desc . - - - - --- Permit Fee Issue Date 75.00 Plan Check Fee .00 Expiration Date Valuation 4/14/12 0 Special Notes and Comments Seperate permit required for electrical c onnection /wiring to new pumps Other Fees STATE DCA SURCHARGE STATE DBPR SURCHARGE 2.00 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 75.00 75.00 Plan Check Total .00 .00 .0 0 .00 .00 .00 Other Fee Total 4.00 4.00 .00 Grand Total .00 79.00 79.00 .00 .00 WIT IS AppROVED ONix IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA 0 GCppb, -S.ayfi,y City of Atlantic Beach ' k , ; . APPLICATION NUMBER j� r S, Building Department � • (To be assigned by the Budding Department.) 800 Seminole Road " `` t,, ,� , � Atlantic Beach, Florida 32233 -5445 O � // - n7 , Phone ( 247 -5826 • Fax (904) 247 -5845 L o ��'; �%' E -mail: building-dept@coab.us Date routed: 4/1/ / i City web -site: http: / /www.coab.us / / APPLICATION REVIEW AND TRACKING FORM Property Address: /Q 44 °,V -' 1.� �1��1 Department review required Yes No / Building Applicant: ( J / J/ (1 / at . L L- Planning & Zoning Tree Administrator Project: /V i) ) Z t P is Utilities ) Public Safety Fire Services R IM .at�'k g 7� h v,4 +"1app "rani r� oo-�nldss i) ' ° ` , Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: Approved. ['Denied. (Circle one.) Comments: "'TTT BUILDING PLANNING & ZONING Reviewed by , i IN ex/CA) Date: /04 /l / TREE ADMIN. Second Review: Approved as revised. ❑Denied. P :A 0 C. ments: / ,, • : IC ILI E /0 PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ['Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 i 0 J CITY OF ATLANTIC BEACH WELL PERMIT APPLICATION Date f — `/^ /7 Owner's Name/1 e //�' .tS Address: / / �e7. 4 /l/9 AA A I Well Address (if different than above): Well Location on Property (i.e. northeast corner, etc.) was' f S 449 3' /Vd%) s Well Installation Contractor Lq/ A y - - /4 i 0 01, s Contractor License No.: /9/ 7 Phone: 2J7 4 19 0 Fax: Contractor Address ,.r!/, O K 4.7 .% �i►'/ G Aor /c/ Check Use of Well: Domestic Irrigation Other # of Wells to be installed: / # of Pumps to be installed: i Estimated- Well Depth: ,0 " Casing Depth: Z O Screen Interval from2Qto ' ■* Well Diameter: [ 4 Casing Material �/lC -- Is address currently connected to the City water system? 5' J Is address currently connected to the City sewer system? ye S Has a Well Permit been obtained from the City of Jacksonville ?, 0 Permit # Does the well require a permit from the St. Johns River Water Management District? (Not required for wells under 2- inches diameter installed by resident or wells under 6- inches diameter if installed by licensed well contractor). e d If permit is required, note Permit Number and attach a copy. NOTE: WHENA WELL IS INSTALLED ON YOUR PROPERTY, YOU MUST INSTALL A REDUCED PRESSURE ZONE TYPE BACKFLOW PREVENTER ON THE CITY WATER SERVICE, ON THE CUSTOMER'S SIDE OF THE METER. THE BACKFLOW PREVENTER MUST BE TESTED BYA CERTIFIED TESTER AND A COPY OF THE RESULTS SENT TO THE PUBLIC UTILITIES DEPARTMENT.