10 Forrestal Cir 2012 elec �� ,• � CITY OF ATLANTIC BEACT
\ ii1
J 800 SEMINOLE ROAD
j � ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
,.
Application Number . . . . . 12-00001655 Date 11/07/12
Property Address . . . . . . 10 FORRESTAL CIR
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
REPLACE BURNT METER CAN
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Owner Contractor
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SMITH SHARON & DUNCAN LIMBAUGH ELECTRICAL CONTRAC
10 FORRESTAL CIRCLE 42 WEST 8TH STREET
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 241-9051
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Permit ELECTRICAL PERMIT
Additional desc CHANGE OUT METER CAN . 00
Permit Fee . . . . 90 . 00 Plan Check Fee
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 5/06/13
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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
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904) 27t0CAd
26 Fax(904) 247-5845
JOB ADDRESS: ��, I C I n� PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 2C"-'V AN PS2-10� VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
❑Residential(Main) Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps # of Meters
❑Commercial(Main) Service
00-100 amps D 101-150amps ❑151-200amps ❑ amps OCT Service amps
Conductor Type Size
[,]Multi-Family(Main)Service
❑0-100 amps 1110 1-I 50amps ❑151-200amps O amps #of Unit Meters
i iTemporary Pole []-amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
[7100 amps ❑150amps 0200amps ❑ amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-3 Damps 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
'-j Swimming Pool [_:i Sign [I 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/MISCELLANEOUS
C7 Replace Burnt/Damaged Meter Can ❑Safety Inspection OPanel Change DOH to UG
WIF
�1 ` s
ther: A •
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 NameC37—C7 CY1G ICc rnb Phone Number
Electrical Company •C ne ?4 qLS( Fax
Co. Address: �hrt?e� City 1 1Jcc,.C�t to Zip�ZZ33
License Holder(Print): State Certification/Registrat
Notarized Signature t e ,{ C tate o f (j
_ b;3rbare K Kenne ry
• 8S7 20 I Z
any�; � SUS befor his ay of �1�111.
i nature of Notary Public �`''