1566 W Park Ter - Meter Can 5 1--Ur f
`'s
t
SS\ CITY OF ATLANTIC BEACH
' •L„ " : ;� 800 SEMINOLE ROAD
" ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
\ J1319 1
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 16 -ELEC -234
Job Type: ELECTRIC ONLY
Description: METER CAN
Estimated Value:
Issue Date: 1/29/2016
Expiration Date: 7/27/2016
PROPERTY ADDRESS:
Address: 1566 W PARK TER
RE Number: 171941 -0000
PROPERTY OWNER:
Name: PHILLIPS, DONALD L & BARBARA B, *
Address: 1566 PARK TER
GENERAL CONTRACTOR INFORMATION:
Name: LIMBAUGH ELECTRICAL CONTRAC
Address: 42 WEST 8TH ST QA ALEX S. LIMBAUGH
Phone: - -
FEES:
Electrical Repairs $35.00
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
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
P ) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: 6rdp i IC Proic_,( 1 ERMIT #
JEA INFORMATION REQUIRED ON ALL PERMITS I O AMPS r - -24CVOLTS 1 PHASE
VALUE OF WORK $ '+ VO
NEW SERVICE Overhead
Underground 1 I Underground up Pole
❑Residential (Main) Service
Wi -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Meters
❑ Commercial (Main) Service
00 -100 amps 0101- 150amps 0151- 200amps ❑ amps El CT Service amps
Conductor Type Size
❑Multi- Family (Main) Service
❑ 0 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Unit Meters
Li Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.)
❑ 100 amps ❑ 150amps ❑ 200amps ❑ amps ❑ CT 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
❑ Swimming Pool ❑ Sign ❑ Smoke Detectors Qty ❑ Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts /amps VALUE OF WORK$
ZEP A S/MISCELLANEOUS
eplace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG
❑ Other:
'enmit 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
gad 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 Phone Number 2-I(7 tCl
Clectrical Company _ II O. . _ t lag _ f _ _1 r . , ,1 P
11 h — G�( Fax
'o. Address: 'f2 L S± / is � i ce C Cwt CIt ti IC. Lip 2
icense Holder (Print): ' 1 State Certification/Registre # n h j 2296
iotarized Signature o Lice e .. +„ _ 1 ,_ _„ 6111 11 •
� ., Notary Public State l da T% day 20 / _
Barbara Kay Ku re ` e this W Y�
My Commission EE 884831
v o c A , o � Expires 03/17/2017 Si a .t V of Notary Public . •