84 W 10TH ST - ELECTRIC 'raj rL`J;rjv�
�� �'\' 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-484
Job Type: ELECTRIC ONLY
Description: meter can
Estimated Value:
Issue Date: 2/25/2016
Expiration Date: 8/23/2016
PROPERTY ADDRESS:
Address: 84 W 10TH ST
RE Number: 170812-1000
PROPERTY OWNER:
Name: VAN FLEET ET AL, DONALD
Address: 84 W 10TH 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
Electrical Repairs $35.00
Total Payments: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE: Willi ALL Ctrl' OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904)247-5826 ax (904) 247-5845
�j
JOB ADDRESS: q L I U s 10-V h - (CP
PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS ` 3 AMPS 21/25 VOLTS / PHASE
VALUE OF WORK$ 5 O
NEW SERVICE n Overhead n Underground 1 IJ Underground up Pole
OResidential(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ nps #of Meters
0Commercial(Main) Service
00-100 amps 0101-150amps 0 151-200amps ❑ .mps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps ❑101-150amps 0 151-200amps _amps #of Unit Meters
0 Temporary Pole ❑ amps
SERVICE UPGRADE 0 amps 0 ' Se _amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCT ,:,S
❑100 amps 0150amps 0200amps 0_ _ OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUT' A( JRY STRUCTURES,ETC.
Outlets/Switches: 0-30amps ,1-: ..cps 101-200amps
Appliances: 0-30amps 31-1 o0amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
USwimming Pool 0 Sign ❑Smoke Detectors Qty 0 Transformers KVA 0Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps • VALUE OF WORK$ .
ZEPAIIRSMISCELLANEOUS
eplace Burnt/Damaged Can ❑Safety Inspection 0 Panel Change 00H to UG
❑Other: � ( r r 1 )et Side_ f4tr cax, y-L,1DS
unit 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
ad 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
ecified 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
,nstruction.
operty Owners Name I1O VC—Lf\V seet one Number " ~`t�J1
ectrical Company L m (xrn EII -�-i cc._-1 �Y }d one - fit U5
I ( // �/J y. t h Ce���"�" 2�1 ���- �Fax_ .
). Address: �2 ( AD -�-C ct Cf-le� - City A i- Clt t C i� te►
cense Holder (Print):(.A(S)( S. LI I I
' State Certification/Registration#
)tarized Sign,t • , ., it I OOP t',k� ai EC 13002296
�}r W Notary Public State of Flo .a ■ /
�P Barbara Kaye m .his 20 1 (0
My Commission
a op? Expires O3l17R017,- , . w f Notary Public 1 1-C'CU,CU K • 1624t4,,,a__,J