357 SARGO RD - ELECTRIC \ s S, CITY OF ATLANTIC BEACH• 800 SEMINOLE ROAD
15 s-) 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-1683
Job Type: ELECTRIC ONLY
Description: WIRE FOR PUMP
Estimated Value:
Issue Date: 7/15/2015
Expiration Date: 1/11/2016
PROPERTY ADDRESS:
Address: 357 SARGO RD
RE Number: 171697-0000
PROPERTY OWNER:
Name: MCCULLOUGH, CHARLES T
Address: 357 SARGO RD
GENERAL CONTRACTOR INFORMATION:
Name: LIN'S ELECTRIC INC
Address: 3840 MAGILL RD QA VIRGIL LINDSEY RHODEN JR
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITI1 All. C11'1 OF A Fl.AN I7C BE k(11 ORDINANCES AND 111E FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach,FL 32233
Ph(904)247-5826 Fax (904) 247-5845
JOB ADDRESS: 357 5(arc,o V . PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS Zoo AMPS --!--71(0 VOLTS ,/ PHASE
VALUE OF WORK$ 4 ° e%
NEW SERVICE ❑ Overhead n Underground Underground up Pole
OResidential(Main)Service
00-100 amps O 101-150amps O 151-200amps amps #of Meters
❑Commercial(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 ❑151-200amps ❑ amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps 0 CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100 amps 0 150amps 0200amps 0 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
0 Swimming Pool 0 Sign ❑Smoke Detectors_Qty 0 Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps • VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can 0 Safety Inspection O Panel Change LJ OH to UG
�
i: ether: �iv1
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
-ead this application and know the same to be true and correct. All provisions of laws and . .•. . • _ _ this work will be complied with whether
>pecified or not. The permit does not give authority to violate the pro . -• :" - - ,4 +aw re_: lation construction or the performance of
:onstruction. ;e. MY COMMISSION.4 011400
11/I ;-' EXPIRES;Apol 24,2017
?roperty Owners Name Y C C U t 10` 1- ''„;zr Bonded Wu Note`!!pub ooefs- mber 2! /— 7061
electrical Company kg k r`... . k.19c r%(.- /Iv-4 Office cone �4i!/3 yi. Fax I/9-7—05-x”
-2o.Address: 3,`t d fa I�� i i eJ City \)4.-y State fl Zip 3L zz 1
License Holder(Print): V t c • i Zuok...Clt- State Certi■ atio ' -:'stration#
Votarized Signature o _ ' ' , • _ •___ �/__-../ L._ ! L /; O- 1 - 'S-2% '0
LT,r". ,:v.• 'n,{.4��� �i .■, e this ,St ay of l�
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=: r cv.:ad" . e of Notary Public Alt k 1 l,.I" 1 /i