1042 Beach Ave 2014 Temp Pole CITY OF ATLANTIC BEACH
s 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
C ill)•
Application Number . . . . . 14-00000233 Date 2/18/14
Property Address . . . . . . 1042 BEACH AVE
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
TEMP POLE 60 AMPS 240VOLTS 1 PHASE
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Owner Contractor
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CLAIRBORNE JAMES B JR LIMBAUGH ELECTRICAL CONTRAC
1042 BEACH AVE 42 WEST 8TH STREET
JEAN KOSKI ATLANTIC BEACH FL 32233
ATLANTIC BEACH FL 322335754 (904) 241-9051
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Permit . . . . . . ELECTRICAL PERMIT
Additional desc . .
Permit Fee 90 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 8/17/14
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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 CSS
Ph (904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: 10 1-2— PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS cj2jXyAMPS c;;;�,e— `VOLTS PHASE
VALUE OF WORK S
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
❑Residential(Main) Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps # of Meters
❑Commercial(Main) Service
❑0-100 amps 0101-150amps 0151-200amps ❑ amps OCT Service amps
Conductor Type Size
❑Mul Family(Main) Service
-100 amps 10 Oamps ❑151-200amps ❑ amps # of Unit Meters
Of emporary 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:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans) VALUE OF WORK$
Qty volts/amps
REPAIRSIMISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change [I OH to UG
'--!Other:
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six mouths. 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. r q(c `—t�p��
Property Owners Name
r7
Phone Number
1 f hone� k-Go5 1 Fax
Electrical Company Ll 1�1 � 1 �
CityE�. t
Co. Address:
License Holder (Print): State CertificatioEG 130022
Notarized Signature of'License Holder � o `
Before nie this ay L`— 20 2
Signature of Notary Public C