389 12 TH ST - ELECTRIC ,s •
s, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
.N\ INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ELEC-1467
Job Type: ELECTRIC ONLY
Description: Electrical repairs
Estimated Value:
Issue Date: 6/23/2015
Expiration Date: 12/20/2015
PROPERTY ADDRESS:
Address: 389 12TH ST
RE Number: 171921-0000
PROPERTY OWNER:
Name: LIGGERG. ROBERT R
Address: 389 12TH ST
GENERAL CONTRACTOR INFORMATION:
Name: LIMBAUGH ELECTRICAL CONTRAC
Address: 42 WEST 8TH ST QA ALEX S. LIMBAUGH
P_hone: - -
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: $94.00
I
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
04) 247-5826 Fax (904) 247-5845
JOB ADDRESS: .J I - �— . re PERMIT#
,YEA LNFORMATION REQUIRED ON ALL PERMITS • AMPS VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground I U Underground up Pole
OResidential(Main) Service
00-100 amps 0101-150amps 0151-200amps 0 amps # of Meters
UCommercial(Main) Service •=.
00-100 amps 0101-150amps 0151-200amps 0 amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main) Service
00-100 amps ❑101-150amps 0151-200amps 0 amps # of Unit Meters
• OTemporary Pole 0 amps
SERVICE UPGRADE ❑ amps 0 CT Service amps
NEW FEEDER(ADDITIONS, ACCESSORY STRUCTURES,ETC.)
0100 amps 0150amps 0200amps 0 amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps . 31-100aitnps • • 101-200amps
Appliances: 0-30amps 31-100amps '• 101-200amps
A/C Circuits: 0-60aps 61-100amps
1 1-leat Circuits: # circuits g' kw
Number of Lighting Outlets Including Fixtures:
OTHER ELECTRICAL PROJECTS
OSwimming Pool 0 Sign 0Smoke Detectors_Qty ❑Transformers KVA 0Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALETS OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace����Bppurrn�nt/Damageed Meter Cant // ❑Safety Inspection °Panel,�C/hange OOH to UG
Other: b' ti 1,,/l itt& (/G A (_4/i 'k /J/n5 C Jl /4 /12
. .. ._..., .. .... ... ., r i �.c�i:.��✓,L.. �i�Lel��i fw 7�'• .'.._',. '.
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.
Iy
Property Owners Name h L1 9c-efr) Phgne Number L1-- 2' 0%1
Electrical Company m` ak, tsca , rc.,- 1&VI-he 2 L ClO5t Fax
Co. Address: 4Z l AP • Sireet City-A±Ion+ICS Erct,eLe E Zip
License Hold• ' i r : _- - '#k. _ Ii VA LA" State Certifcati.ontt1 601296
r
�' ryo S of I nda l� ,� '�i •
Notarized � "' Q� r �,�'�•�r��i ll7s c J My Commission EE 884631
• a r,d' Expires 0 311 7/2 01 e o e ,e.thus ays ■ 20
Signature of Notary Public IL V CL.AD 1 •. 16 '