16 E DUTTON ISLAND RD - ELECTRIC ee
CITY OF ATLANTIC BEACH
s�:� �J 800 SEMINOLE ROAD
ti ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ELEC-2368
Job Type: ELECTRIC ONLY
Description: CHG AC BREAKERS
Estimated Value:
Issue Date: 10/7/2015
Expiration Date: 4/4/2016
PROPERTY ADDRESS:
Address: 16 E DUTTON ISLAND RD
RE Number: None
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
Lighting Outlets, Including Fixtures $1.20
Trade Permit Base Fee $55.00
Total Payments: $60.20
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph(904) 247-5826 F (904)247-5845 15 - E - —Z36/8
JOB ADDRESS: I V T) ,Lticn T Ict nd ic cod L -s--\-- PERMIT#
'T VOLTS_ ....._i9:04
VALUE OF WORK$ /a66 '6
NEW SERVICE ❑ Overhead ❑ Underground DJ Underground up Pole
:Residential(Main) Service
❑0-100 amps C 101-150amps ❑151-200amps C amps #of Meters
:Commercial(Main) Service
C0-100 amps ❑101-150amps D 151-200amps amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps ❑101-150amps ❑151-200amps C amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100 amps C 150amps 0200amps C amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-3 Damps 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)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
CReplace Burnt/Damaged Meter Can [JSafety Inspection ❑Panel Change DOH to UG
'Other: C4V 2p I2AIc €$ 4 ego-Wm/02-7°4 /h u Zfl t i.✓ WI l ei
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. I�f�-`�'
Property Owners Name ._
Y �G C Phone Number c�C`'1"4-CAE)
I I' F (G�i . t'P on-, • I Fax
Electrical Company�-1�1(�1 1 � �'r� I,..
Co.Address:
`T7 l � T OR ity Ai b r r v ta1E Vip2Z23�J
License Holder(Print): c.l c• L1 ba �I' State Certification/Regi 3iike% (
Notarized Signature o i • 4, ' • _ .rill a'
Noon Public slat•o�,Florida ' IP . o- 0 I
�a'"�"c�y. My cam aye+EEneehd�6Y3ore -e this . .
'.„,„F Expires 03N7t2017 •. s. . of Notary Public C 1�