275 5th St - Electric - Reground House i!rL`.1r
0
0 , 1!;. CITY OF ATLANTIC BEACH
AL s 800 SEMINOLE ROAD
J '", ATLANTIC BEACH, FL 32233
K\` INSPECTION PHONE LINE 247 -5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 16- ELEC -73
Job Type: ELECTRIC ONLY
Description: ELECTRIC - REGROUND HOUSE
Estimated Value:
Issue Date: 1/11/2016
Expiration Date: 7/9/2016
PROPERTY ADDRESS:
Address: 275 5TH ST
RE Number: 172558 -0000
PROPERTY OWNER:
Name: KUBIAK LIVING TRUST, LAVINIA H, *
Address: 275 5TH 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
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) 24'H-82,6 Fax (904) 247 -5845 j e- .15C - _7 3
JOB ADDRESS: ,;271 S h +t t PERMIT #
JEA INFORMATION REQUIRED ON ALL PERMITS I (.9 OAMPS c LTS . PHASE
VALUE OF WORK $
NEW SERVICE 1 1 'overhead n Underground 1 IJ Underground up Pole
Residential (Main) Service
00 -100 amps 0101- 150amps [ 151- 200amps El amps # of Meters
Commercial (Main) Service
110 -100 amps O 101- 150amps O 151- 200amps El amps il CT Service amps
Conductor Type Size
i Multi - Family (Main) Service
A 0 -100 amps O 101- 150amps O 151- 200amps ❑ amps # of Unit Meters
❑Temporary Pole O amps
SERVICE UPGRADE O amps O CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.)
O 100 amps O 150amps 0 200amps O 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
O Swimming Pool O Sign O Smoke Detectors Qty 11 Transformers KVA O Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts /amps VALUE OF WORK $
REPAI ISCELLANEOUS
L eplace Burnt/Damaged Meter Can 11 Safety Inspection 11Panel Change OOH to UG
Other: l q row - c t hL)usc
Permit becomes void if work oes 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 ordinances governing this work will be complied with whether
>pecified 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. LGV KLW � 2 ropey Owners Name 1 n 1 G �--V jai( Phone Number 4 420 5
Electrical Compan b 11,..,__. - eciy1 Ln ' nee Phone 2_41" 0 6( Fax
"2o. Address: fh
ddres -[ 2 s Sire i City Ai Ira ntis Emushle ( S22g
Acense Holder (Print): G te/X S • LI F , 1 ; � State Certification/Registration # E.C1
Votarized . .f, . • ' or k .r1/�a.•l� I C►1�
Notary Public State of Florida
Barbara Kaye Kenn�ltfore , e this 1 , a e C:- f 20 •
c p ` My Com EE 884631
b >,,.tr Expires 03N7/2017 „ i., e of Notary Publi V- K,. • _ ,