483 SELVA LAKES DR - ELECTRIC f- , J
/ \S, CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
?> �r 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-933
Job Type: ELECTRIC ONLY
Description: ELECTRICAL - PANEL CHANGE
Estimated Value: $1,232.00
Issue Date: 4/22/2016
Expiration Date: 10/19/2016
PROPERTY ADDRESS:
Address: 483 SELVA LAKES CIR
RE Number: 172027-5030
PROPERTY OWNER:
Name: LONAS, ERIN F
Address: 483 SELVA LAKES CIR
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233 I//
LA-Cs (904)247-5826 Fax (904) 247-5845 16 -G Le C-c1 3 3
JOB ADDRESS: Va @Aces .1J1� ( 'te-- PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS __AMPS 940 VOLTS ( PHASE
VALUE OF WO' gi$ 4 a,00
NEW SERVICE n Overhead n Underground I II Underground up Pole
❑Residential(Main) Service
00-100 amps 0101-150amps 0151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
00-100 amps 0101-150amps 0151-200amps 0 amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps 0101-150amps 0151-200amps 0 amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE 0 amps 0 CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps 0150amps 0200amps ❑ 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
❑Swimming Pool 0 Sign ❑Smoke Detectors Qty ❑Transformers KVA DMotors hp
?IRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
tEPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection anel Change DOH to UG
❑Other:
: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 Er 1 f L.O m CI S Phone Number CD t 1^ SC-1— O- ‘O
ectrical Company LI mom, E(�2C 1ri Cat C(-fa(i•,,� h
rice Phone Z`f� Fax
Fax
). Address: 42 L3PS Cam' Sk •.e t City +1 Cflt I C 7�c,plit�— fl Zip 32.233
cense Holder (Print): (J&( S • ' • o ii11 h State(Certification/Registration#
ltarized Signature of License Holder X ' 1
Before me this I' da of • 20 1 �j
Signature of Notary Public. C LLGiN! _ K. r-12_1■-1,-
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
PHONE (904) 247-5855
Cashier Id: aspcust\atlblae
Receipt Date: 4/22/2016
Receipt Number: 0S-69734
Job ID: 16-ELEC-933 - ELECTRICAL - PANEL CH
ANGE EDBPR - State Elec DBPR Surcharge $2
.00
Job ID: 16-ELEC-933 - ELECTRICAL - PANEL CH
ANGE EDCA - State Elec DCA Surcharge $2.0
0
Job ID: 16-ELEC-933 - ELECTRICAL - PANEL CH
ANGE ELIO - Electrical Repairs $35.00
. Job ID: I6-ELEC-933 - ELECTRICAL - PANEL CH
ANGE TP - Trade Permit Base Fee $55.00
Amount Due: $94.00
Tender Information: Check # 37502 $94.00 ,
Tender Type: CK
Tender Amount: $54.00
•
Change Due: $0.00
•