2279 Seminole Road #7 - Electric Only 6 Fixtures CITY OF ATLANTIC BEACH
4 s 800 SEMINOLE ROAD
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: 16 -ELEC -131
Job Type: ELECTRIC ONLY
Description: 6 fixtures
Estimated Value:
Issue Date: 1/19/2016
Expiration Date: 7/17/2016
PROPERTY ADDRESS:
Address: 2279 SEMINOLE RD UNIT 007
RE Number: 168345 -0100
PROPERTY OWNER:
Name: DUFFEY TRUST, PELICAN DUNES
Address: 2279 SEMINOLE RD APT 7
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 $3.60
Trade Permit Base Fee $55.00
Total Payments: $62.60
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION /
CITY OF ATLANTIC BEACH V
800 Seminole Rd, Atlantic Beach, FL 3223 1"
Ph 904) 247 -5826 Fax 904) 247 -5845
JOB ADDRESS: Aai G i no le (, (J d PERMIT #
JEA INFORMATION REQUIRED ON ALL PERMITS 200 AMPS /v OLTS / PHASE
VALUE OF WORK$ l 5 CO
NEW SERVICE I I Overhead n Underground 1 IJ Underground up Pole
❑Residential (Main) Service
00 -100 amps ❑ 101- 150 amp s ❑ 151- 200amps ❑ amps # of Meters
❑ Commercial (Main) Service
❑ 0 -100 amps ❑ 101- 150amps 0151- 200amps ❑ amps ❑ CT Service amps
Conductor Type Size
❑Multi- Family (Main) Service
00 - 100 amps ❑ 101- 150amps ❑ 151- 200amps LI amps # of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.)
❑ 100 amps ❑ 150amps 0200amps ❑ amps ❑ CT Service amps
ADDITIONS, REMODELS REPAIRS, BUILD -OUTS, ACCESSORY STRUCTURES, ETC.
Outlets /Switches: td . 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: 3
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
[Replace Burnt /Damaged Meter Can ❑ Safety Inspection ❑Panel Change ❑ OH to UG
❑ Other:
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 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.
?roperty Owners Name Kosc aS SCG lc i otci K I S hone Numbed' Z 11 202G
3lectrical Company L1 _t _ _ 4 A An . ( CLI Phone — Ci
,e CSI Fax
o. Address: 42 WPSt ► I rett, city fk vi n f i G G t --Zip 2 225
License Holder (Print): a( €c S. Liii4s, .1 , State Certification/It ataan.44 6
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Votarized Signature of License Holder I � • i� i r
eo - lethis •.yo _ 20 1
Notary Pudic State • Florida
Barbara Kaye Ken ily y 1 . / to �,) K K. I k x
v M omission EE 8 a e of Notary Public _ C L� (aJ
orw F- xf�ros
A.