172 6th St. ELECTRIC It CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ELEC-557
Job Type: ELECTRIC ONLY
Description: REPLACE BURNED METER CAN LUGS
Estimated Value:
Issue Date: 3/12/2015
Expiration Date: 9/8/2015
PROPERTY ADDRESS:
Address: 172 6TH ST
RE Number: 170150-0000
PROPERTY OWNER:
Name: HOOTEN II, M EARL B
Address: 172 6TH ST
GENERAL CONTRACTOR INFORMATION:
Name: LIMBAUGH ELECTRICAL CONTRAC
Address: 42 WEST 8TH ST QA ALEX S. LIMBAUGH
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Electrical Repairs $35.00
Trade Permit Base Fee $55.00
Total Payments: $94.00
PERIT 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) )47-5826 Fax (904) 247-5845
JOB ADDRESS: la� PERMIT#
,IEA INFORMATION REQUIRED ON ALL PERMITS 5CCAWSc�— L 0VOLTS PHASE
VALUE OF WORKS
NEW SERVICE ❑ Overhead ❑ Underground ❑J Underground up Pole
❑Residential (Main) Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps # of Meters
CCommercial (Main) Service '
-1 ilb
1]0-100 amps 0101-150amps 0151-200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main) Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps # of Unit Meters
[]Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STS WCTURES,ETC.)
❑10 amps ❑150amps 0200amps 0 amps OCT Service amps
ADDITIO S,REMODELS,REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC.
Outlets/Switches: 0-30amps 3 1-1 00ai-A-ps 101-200amps
Appliances: 0-30arrips 31-100amps 101-200amps
A/C Circuits: 0-60a%ps 61-100amps
Heat Circuits: # circuits @ ' kw
Number of Lighting Outletj,,Including Fixtures:
OTHER ELECTRICAL PROJECTS
LjSwpmming Pool [I Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans) VALUZ OF WORK S
Qty volts/amps
ItEPAIRS MISCELLANEOUS
TtA�Keplace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG
.Other: lot rr' I
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six rnotiths. I hereby certify that l 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
,peci lied or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or 3the 002296erformanc f
E
y
,onstru tion. �(
Property Owners Name l l 1 Ph ne Number
i one Fax
Electrical Company _
Co. Address: + � City I�fl+l� _�iip�
License Ilol
State Certification/Registration # r
No Public State Florida
Notarized ig�I � r ap�I ohkr
�p� y Commission EE.884631 �j _ A
d' Expires 03/17/2017 e t11is d L C— -- 0
Signature of Notary Public C