2359 SEMINOLE RD - ELECTRIC PANEL CHANGE rJJf1
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
9-1-0 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-1873
Job Type: ELECTRIC ONLY
Description: ELECTRIC - PANEL CHANGE AND FLOOD LIGHTS
Estimated Value: $13,264.00
Issue Date: 8/17/2016
Expiration Date: 2/13/2017
PROPERTY ADDRESS:
Address: 2359 SEMINOLE RD
RE Number: 168349-0000
PROPERTY OWNER:
Name: JACOBSON, SAMUEL S
Address: 2359 SEMINOLE RD
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233 // �
Ph(904) 247-5826 Fax (904) 247-5845 ��P`€.LCC-1 &7 3
JOB ADDRESS: ,-
;4 j 5 q ;elm I no le_ C_CI PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS W AMPS twoVOLTS / PHASE
iik- I�4VALUEOFWORK ' 6 ,eV
`�
NEW SERVICE ❑ Overhead - 1J up
Underground OJ Underground Pole
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❑Residential (Main) Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
❑Commercial(Main) Service
❑0-100 amps C 101-150amps ❑151-200amps ❑ amps OCT Service amps
Conductor Type Size
Ll Multi-Family(Main) Service
00-100 amps C 101-150amps ❑151-200amps ❑ amps #of Unit Meters
El Temporary Pole ❑ amps
SERVICE UPGRADE LI amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps `1150amps 11200amps E amps ❑CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
CI Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA [Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection XPanel Change ❑OH to UG
IOther: "r/, 6 i.,A ate do,,,, A;
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
read 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
specified 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
construction. 1,,c^ /
Property Owners Name JCS •l J CLOG 9 X.J n Phone Number 2 t4 C ` A 0Electrical Company Li m - l Uc& Y i Cci C x Vc.th Phonec24 I- Fax
Fax
Co. Address: 4 Z }h S� --e--e" City t(Gnt IC:& &-G Ir _Zip"3ZZ3 3
1 License Holder(Print): c) ( t1 State Certification/Registration#
Notari ed Si nature License Holder ' � ,!0 1 EC 13002296
Notarized g of twel
- 3 r me this l •ay • a 20
Notary Public State of Florins .
Barbara Kaye Kennelly Si_ ature of NotaryPublic IGO k / lJ
(4)
My Comm1 � `-�v`� �`- —�Expires 03/17/2017