376 MAIN ST OVER HEAD TO UNDRGRD �
I f f;
" '' S \ CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
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: 16 -ELEC -276
Job Type: ELECTRIC ONLY
Description: OVERHEAD TO UNDERGROUND 150 AMPS
Estimated Value:
Issue Date: 2/4/2016
Expiration Date: 8/2/2016
PROPERTY ADDRESS:
Address: 376 MAIN ST
RE Number: 170872 -0000
PROPERTY OWNER:
Name: HROMCO, GEORGE S & PAMEL, *
Address: 376 MAIN ST
GENERAL CONTRACTOR INFORMATION:
Name: LIMBAUGH ELECTRICAL CONTRAC
Address: 42 WEST 8TH ST QA ALEX S. LIMBAUGH
Phone: - -
FEES:
Trade Permit Base Fee $55.00
State Elec DCA Surcharge $2.00
State Elec DBPR Surcharge $2.00
New Single Family Electrical $60.00
Total Payments: $119.00
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 L*1 (I/
800 Seminole Rd, Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: - 7 0 j r St n PERMIT #
JEA INFORMATION REQUIRED ON ALL PERMITS APS J VOLTS `/
M PHASE
VALUE OF WORK $ / @ 4 2
NEW SERVICE 1 1 Overhead 1 1 Underground 1 U Underground up Pole
❑Residential (Main) Service
00 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Meters
❑ Commercial (Main) Service
00 -100 amps ❑ 101 150amps ❑ 151- 200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi- Family (Main) Service
❑ 0 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Unit Meters
❑ Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.)
❑ 100 amps ❑ 150amps 0200amps ❑ amps II CT Service amps
ADDITIONS, REMODELS, REPAIRS, BUILD -OUTS, ACCESSORY STRUCTURES, ETC.
Outlets /Switches: 0- 30amps 31- 100amps 101- 200amps
Appliances: 0- 30amps 31- I00amps 101- 200amps
A/C Circuits: 0- 60amps 61- 100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
LI Swimming Pool ❑ Sign 1 Smoke Detectors Qty ❑Transformers KVA El 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:
Pennit 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 Nam: "$ • " a t a 0 C Phone Number - -(:) J c
Z 1 1
Electrical Company _ m A . II _; 1 i _ _ s ce hone L'C1Oj( Fax
io. Address: 42 (j JCS 'f h f
Cit fltlG- 11fIC.. @�mG tSase —Zip SZZ-3
Acense Holder : Li Print ( ,' i
Holder ( Print): (�[` �• m i h State Cert r�t�on2296
Notarized Si , . r' 1 ' • f • . , , • 1 ! 3,I �, 'l 7 V
1
Notary Pau blic State of ontia /_ 1
Barbar Kaye KenPyTOre e this a d. l7-� 20
+ f My Commission EE 884631
vta ' ow Expires 03/17/2017 Si a . e of Notary Public Ilt, tU C IC . requit-(11.