Permit Elec 175 15th St 2011 r CITY OF ATLANTIC BEACH
r 800 SEMINOLE ROAD
;;> ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 11- 00003012 Date 12/15/11
Property Address 175 15TH ST
Application type description ELECTRIC ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
replacing 3 recptcles
Owner Contractor
JOHNSON R MARK & TERESE M LIMBAUGH ELECTRICAL CONTRAC
175 15TH STREET 42 WEST 8TH STREET
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 241 -9051
Permit ELECTRICAL PERMIT
Additional desc .
Permit Fee . . . 56.80 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 6/12/12
Other Fees STATE ELEC DCA SURCHARGE 2.00
STATE ELEC DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 56.80 56.80 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 60.80 60.80 .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
Ph (904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: I l 5 ( h S. PERMIT #
JEA INFORMATION REQUIRED ON ALL PERMITS -CI AMPS f VOLTS
PHASE
VALUE OF WORK $ 5 , -
NEW SERVICE n Overhead n Underground D Underground up Pole
❑Residential (Main) Service
00 -100 amps ❑ 101- 150amps ❑ 151- 200amps 0 amps # of Meters
❑Commercial (Main) Service
00 -100 amps ❑ 101- 150atnps ❑ 151- 200amps 0 amps OCT Service amps
Conductor Type Size
OMulti- Family (Main) Service
00 -100 amps ❑ 101- 150amps 0151- 200amps ❑ amps # of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE 0 amps 0 CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.)
0100 amps 0150amps 0200amps ❑ 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
0 Swimming Pool ❑ Sign ❑Smoke Detectors Qty ❑Transformers KVA 0 Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans & Fire Alarm Checklist)
Qty volts /amps VALUE OF WORK $
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Mete Can ❑Safety Inspection OPanel Change 0 0H to UG
Other: / / eI / A, d i
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. M
Property Owners Name I tG-1r K - 3 C)1 � � (r Phone Number (`2G - � --�- CR
Electrical Company LI r t EleCkri C�_L 00a-VrOrI -i (5 ce Phone C IO` �� 2 -4 — Q ttk
co. Address: �t 2 LAS{ V\ S
City ( t 1C n f i C ��Ct
Y "'State {� I Zip . Z 3 3
License Holder (Print): � t� 1 , ., O ,;..11 'ilk , . , State Certification/Registrati
Notarized Signature of License Holder lE v ! ' 1l 13002296
Sworn and subs g ibe before me this f c ay of _ Dec crx_ 4. 'L20 I l
'
Signature of Notary Public ) C l ,CA 4-- I6 - _