2223 ALICIA LN - ELECTRICAL REPAIR �� r , ATLANTIC BEACH
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PERMIT RECEIPT
PERMIT DESCRIPTION: Electrical repairs
PERMIT NUMBER: 15-ELEC-1606
ADDRESS: 2223 ALICIA LN
OWNER:
DATE ISSUED: 7/6/15
FEES DUE:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Electrical Repairs $35.00
Trade Permit Base Fee $55.00
Totals:
$94.00
07/06/2015 15:06 904-2490703 BROOKS AND LIMBUAGH PAGE 01/01
ELECTRICAL PERMIT APPLICATION
ef.,.• CiTY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach,FL 32233
rr}} h rr Ph(904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: c,4�o`ti - LC (16- PERMIT#
SEA INFORMATION REQUIRED ON ALL PERMITS
AMPS VOLTS PHASE
VALUE OF WORK S .�
Underground fT Underground up Pole
NEW SSERVICE SERVICE 1=3 round Overhead ❑ g
:1Residentiai(Main)Service
00-100 amps ❑101-150amps r1151-200am.ps C:I._ _amps #of Meters_
[.!Commercial(Main)Service p�11151-200am 5 III amps OCT Service _amps
I.10-100 amps 01101-150amps
Conductor Type Size
]Mufti-Family(Main)Service s #of Unit Meters .
110-100 amps 01101-150amps 0151-200amps �) am— p
❑Teooiporary Pole LJ _amps
SERVICE UPGRADE • Ll _amps Li CT Service_ amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100 amps U150amps L1200amps n_ amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,2{TC.
Outlets/Switches: _ . r _0-30amps 31-100asnps
Appliances:
31100arnp, s 101-200amps ppliances: 0�34amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits G kw
Number. of Lighting Outlets, including Fixtures:
OTHER ELECTRICAL PROJECTS 1:ITransformers KVA IMotors hp
❑Swimming Pool U Sign �7f Srnoke Detectors Qty xners
FIRE ALARM SYSTEM (Requires 3 sets of plans) VALUE OF WORX S.
_
Qty volts/amps
REPAIRS/MISCELLANEOUS
❑Replace Bumt/Dama.ged Meter Can 1_1 Safety Inspection LPancl Change I IOH to UG
i)ther: /iA#i'1N /d si•• 2
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
.cad this application and know the same to he true and correct. AiI provisions of laws and ordinances governing this work will be complied with whether
peciflcd 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
:onstruction.
'roperty Owners Name '( .Y1 L_1 1-11. 11 _ Phony;Number qCS— —13 ._..- acti‘ci. .
?lectrical Company rr __
.7o. Address: 2- ���`c* -1 l • CityP iG > p 2�g
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i .tc nse Helder(Print):/---- lam _ ,. ,�'t }-. *..}Mate Corti o e jg1 9l .� r
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fit -,
Barbara Kaye KeatneMY �_
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