660 Orchid St new service elec 2012-11-29 08:07 BuRding Dept. 247 5845 >> 904 2490703 P 1/1
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: �2(Q n r Ch i"da —PERMIT
JEA INFORMATION REQUIRED ON ALL PERMITS !�_Z) AMPS VOLTS PHASE
VALUEOFWORKS
NEW SERVICE El Overhead nderground Underground up Pole
,AResidential(Main) rvice
�00-100amps 101-150amps 1.115 1-200amps I] amps h!of Meters
0 Commercial(Main ervice
0 0-100 amps 0 10 1-I 50amps 0 1 51-200amps 0 anips nCT Service amps
Conductor Type Size
�]Multi-Family(Main)Service
0 0-100 amps 0101-150allips 0 151.200arrips 0 amps 9 of Unit Meters
JTemporary Pole 0 amps
SERVICE UPGRADE D amps 0 CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURE S,ETC.)
0100amps 0150amps [3200amps 0 amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switclies: 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 @ kw
Number of Lighting Outlets, Including Fixtures:
OTHE R I ME CTRICAL PROJECTS
OSwimmingPool QSign 0 Smoke Detectors_Qty LDTransformers KVA 0 Motors lip
VME ALARM SYSTEM (Requires 3 sets of plans)
Qty_volts/amps VAL UE'_0 F WORK S
RE PAW/NUSCELLANE OUS
I]Replace Burnt/Damaged Meter Can 0 Safety inspection . OPanel Change o OH to UG
[]Other: I
Permit becomes void if work does not commence within a six morith period or work issu%pended 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 I'lic permit doe-,not give authority to violate the provisions of any otherstate or local law regulation construction or the performance of
construction.
Property Owners Phone Number 2-4 t- 12Z Z__
Electrical Compan mLcini one v2Z 2— Fax
16. do
tC Zi-D SZ2_3�3
Co. Address:ql,. t—)esy st S'�teet, City, dL�ate
License Holder(Print): 011— Nu i State Certification/Registration#
Notarized Signature of License Holder EC13002296
Before me this QA_&kNk_115
X ry,
Signature of NmotaryPublic 0
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
I ri
Application Number . . . . . 12-00001752 Date 1/03/13
Property Address . . . . . . 660 ORCHID ST
Application type description SINGLE FAMILY RESIDENCE
Property Zoning . . . . . . . RES GEN 2F DISTRICT
Application valuation . . . . 75000
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Application desc
5 BEDROOM DETACHED SFR
--------------------------------------------------------------
Owner Contractor
------------------------
------------------------
BEACHES HABITAT FOR HUMANITY BEACHES HABITAT
1671 FRANCIS AVE. 1671 FRANCIS AVENUE FL 32233
ATLANTIC BEACH FL 32233 ATLANTIC BEACH
(904) 241-1222 (904) 241-1222
--- Structure Information 000 000 NEW HOME
Construction Type . . . . . TYPE 5-B
occupancy Type . . . . . . RESIDENTIAL
Flood Zone . . . . . . . . ZONE X
---------------------------------------------------------------------- -----
Permit ELECTRICAL PERMIT
Additional desc 150 AMP UNDERGROUND
Sub Contractor LIMBAUGH ELECTRICAL CONTRAC . 00
Permit Fee . . . . 115 . 00 Plan Check Fee
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 7/02/13 --------------
-------------------------------------------------------------
Special Notes and Comments
Avoid damage to underground water/sewer utilities . Verify
vertical and horizontal location of utilities . Hand dig if
necessary. If field coordination is needed, call 247-5834 .
Ensure all meter boxes, sewer cleanouts and valve covers
are set to grade and visible.
A sewer cleanout must be installed at the property line.
Cleanout must be covered with an RT1 concrete box with
metal lid. Cleanout to be set to grade and visible .
Full right-of-way restoration, including sod, is required.
Roll off container company must be on City approved list
and container cannot be placed on City Right-of-Way.
(Approved: Advanced Disposal, Realco, Shappelle ' s and Waste
Management . )
Full erosion control measures must be installed and
approved prior to beginning any earth disturbing
activities . Contact Public Works (247-5834) for Erosion
and Sediment Control Inspection prior to start of
construction. Aff 8F]WJ'GAT4WAA9j-4CWR*WEsCPW-rHE FLORIDA
PERMIT ISZ0iW0VFCb-(6R1T-P&
BUILDING CODES.
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
-5814
INSPECTION PHONE LINE 247
Page 2
Application Number . . . . . 12-00001752 Date 1/03/13
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Special Notes and Comments
FOR AN APPROVED FINAL MECHANICAL A/C INSPECTION, A STICKER
SHALL BE INSTALLED ON THE AHU TO VERIFY THAT DUCTS HAVE
BEEN SEALED, A CERTIFICATION SHALL BE ON SIGHT FOR THE
INSPECTOR STATING THAT THE A/C SYSTEM PASSED THE "AIR BLAST
INSPECTION" FROM AND INDEPENDENT TESTING AGENCY.
*SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST
CONTROL COMPANY PRIOR TO C.O.
WINDOW AND DOOR INSPECTION:
*INSTALLATION INSTUCTIONS REQUIRED
*ALL STICKERS ARE TO REMAIN ON THE WINDOWS
*PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE ELEC DCA SURCHARGE 2 . 00
STATE ELEC DBPR SURCHARGE 2 . 00
-- -------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 115 . 00 115 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 119 . 00 119 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
06/10/2013 10:09 904-2490703 BROOKS AND LIMBUAGH PAGE 01/01
EARLY POWER AGREEMENT & RELEASE
CITY OF ATLANTic BEACH
Electric power is requested now under the conditions and terms of this fully executed Agreement&Release
Job Address:
ach if
V.,
Permit No. tZ , Service Type(Circle One): Overhead Underground
We,the undersigned General Contractor and Electrician,understand and agree:
ureJy for our construction conve;)ience, it is not required by Codes" and does not
nspecti,ons or the C/O(Certificate of Occupancy)-ffi .ore occupaTFcy,
s bstlytutpeofworfFinallij) at must be issued b�l
and as such is at the discretion of the Building Official.
2. The City of Atlantic Beach will make a special inspection prior to the early power energizing. All rough
inspections must have prior Approval, inelfiding mefer base connections.
3. Occup ancy qr use of the new construction before a formal C/O constitutes fraudulent use of the carl�
c
electric service. Such action is expressly prohibited and penalized by The City of Atlantic Bea
Ordinances. A violation of this Agreement sball result in. a request for prompt removal of electric service
after a twenty-four hour notice.
4. "Early Power"release authority,is the Electrician and/or the Contractor and must not occur before:
a. Eq ' ment,devices and fixtures are installed(or blanked off)safety.
u at inspection).
b. Panel?is complete with brek*ers and cover,and(labeling reqiiircd at fin
c. Service connection and grounding is complete.
d. The electric system has safely passed through electrical check.
c. Meter ran is pennanently mdr�ed with address.
f. Temporary address numbers displayed (Permanent numbers arerequired for C/O).
5. This fully completed form is to be submitted to theBuildiug Department by hand,mail or Ux.
6. Future such Agreements will not be accepted from those who violate MY One of the above items.
CONTRACTOR DATE -7
PRINT NAME
F-LECTRICTAN A. DATE
LA_
PRJNT NAME
800 Seminole Road�Atlant�c Beacb FL 32233
Phone: (904)247-5826 Fax: (904)247-5845 revised 11.29.*06