Permit Elec Service Repair 400 Levy Rd 2012 s
IT 41 _ f CITY OF ATLANTIC BEACH
, g 800 SEMINOLE ROAD
j . 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
Application desc
REPAIR OVERHEAD SERVICE SUPPORT AND HARDWARE
Owner Contractor
FREEDOM INDEP BAPTIST CHURCH UNITED ELECTRIC COMPANY OF
JACKSONVILLE
ATLANTIC BEACH FL 32233 5716 ST. AUGUSTINE ROAD
JACKSONVILLE FL 32207
(904) 731 -4210
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
Other Fees STATE ELEC DCA SURCHARGE 2.00
STATE ELEC DBPR SURCHARGE 2.00
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 $$0 5
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
d 1 Ph (904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: L 2 v Y {Z dC PERMIT # / 2 _ 3/0
JEA INFORMATION REQUIRED ON ALL PERMITS a0 0 AMPS .2 `1 0 VOLTS S ;n PHASE
,VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑J Underground up Pole
❑Residential (Main) Service
0 0 - 100 amps ❑ 101 150amps ❑ 151 200amps ❑ amps # of Meters
❑ Commercial (Main) Service
0 0 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi - Family (Main) Service
0 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 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:
O'1'IiER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors Qty ❑Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans & Fire Alarm Checklist)
• volts /amps VALUE OF WORK $
REPAIRS 1 : CELLANEOUS
eplace Burnt/Damaged Meter Can I ❑Safety Inspection ❑Panel Change ❑ OH to UG
.Other: RL- a eci, St rvi Cc.. Aril, ss Svee t ?c rus
�J II
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 �rt Z (:10/1-, Tr, e. pin j ti A 416 �' d daL Phone Number 1 7 -
Electrical Company (L\ 4 t.1 C D P JGX Office Phone 131-42-10 Fax 131.5311
Co. Address: 571 It S �- f9 uS�"+ ^c � � � City SG State `L Zip 3? 01
License Holder (Print): 3 . f i"T' n S ate Certification /Registration # CC 00003H
Notarized Signature of License Holder �
r MARILYN E. TARPLEY
;� • �''�s Sworn and subscribed before e this /5-11 day of iik14QC14 20P-
eR1 :r MY COMMISSION # DD 875577 ,
. ° S. EXPIRES: March 30, 2013 i
' `Bonded Thru Notary Public undenvrrters
Signature of Notary Public • 1111, ��i