Permit Elec Repairs 400 Levy 2012 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00000310 Date 3/19/12
Property Address . . . . . . 400 LEVY RD
Tenant nbr, name . . . . . . FREEDOM INDEP BAPTIST
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 800
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Application desc
REPAIR OVERHEAD SERVICE SUPPORT AND HARDWARE
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Owner Contractor
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FREEDOM INDEP BAPTIST CHURCH UNITED ELECTRIC COMPANY OF
JACKSONVILLE
ATLANTIC BEACH FL 32233 5716 ST. AUGUSTINE ROAD
JACKSONVILLE FL 32207
(904) 731-4210
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Permit . . . . . . ELECTRICAL PERMIT
Additional desc . . REPAIR OH SERVICE TO CHURCH
Permit Fee . . . . 90 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 9/15/12
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Other Fees . . . . . . . . . STATE ELEC DCA SURCHARGE 2 . 00
STATE ELEC DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 90 . 00 90 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 94 . 00 94 . 00 . 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
ALI Ph(904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: . Lcvy PERMIT
I
JEA INFORMATION REQUIRED ON ALL PERMITS a 0 0 AMPS VOLTS 5 1 A 1-< PHASE
k2l
,VALUE OF WORK S
NEW SERVICE El Overhead Underground Underground up Pole
OResidential(Main) Service
00-100 amps 0 10 1-1 50amps 0 151-200amps amps # of Meters
OCommercial(Main) Service
00-100 amps 0 10 1-I 50amps 0 151-200amps O—amps OCT Service amps
Conductor Type Size
OMuld-Family(Main)Service
00-100 amps 0 101-150amps 0 151-200amps O_amps of Unit Meters
0 Temporary Pole O_amps
SERVICE UPGRADE -amps 0 CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100amps 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 3 1-1 00amps 101-200amps
A/C Circuits: -0-60amps 61-100amps
Heat Circuits: # circuits
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
OSwimmingPool OSign 0 Smoke Detectors_Qty OTransformers KVA 0 Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans&Fire Alarm Checklist)
volts/amps VALUE OF WORK$
(:'REPAIURS ELLANEOU'S
Cl
eplace Burnt/Damaged Meter Can 0 Safety Inspection 0 Panel Change OOH to UG
XOther: R L- c' S e r v* ct- rn (ho
_0 _5se�)t ,- Tvppor� ?'(11"ct- rvAl ka4wc-rc
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.
Property Owners Name Frf-e,Ll�--% -rr%jt Phone Number -7 2 '7
Electrical Company—�,A,+ ,t J c' Jc-X Office Phone 31-4 2-1 10 Fax-131-53) 1
Co.Address: 571(f S�, hW!5V5�-'-" 0 city State Fe- Zip 3 0 7
License Holder(Print): 70�0-" 1'; F7 State Certification/Registration#CC.0000JYV
Notarized Signature of License Holder
MARLYN E.TARPLEY man�/si ibseri bed lb/e�/fbre n4 this dayof WA&C- 4 20 P-
19 MWION#DD 875577 Swo
MY com
EXPIRES:March 30,2013
B nded Thru Notary Pubiic Unde rs
Signature of Notary
Public
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