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HomeMy WebLinkAbout353 (5)ELECTRICAL PERMIT APPLICATION City of Hermosa Beach - Community Development Department NEW BRANCH CIRCUITS - LIGHTING OR GENERAL USE AND DWELLING APPLIANCES QTY Amount JOB ADDRESS: 353 LonAgaor) V 1. 15 or 20 AMP., 120V - 240V a. 1-10 Circuits, Total Fee b. 11-40 Circuits, Total Fee c. 41 or More Circuits, Total Fee 2. 15 or 20 AMP. @ 208V to 277V (Commercial) 3. All Other Lighting Circuits 600V or Less $43 $88 $131�" S9-0 JOB DESCRIPTIO : 1) �� ,' ` C"t o►'Y� $22 each $22 each ADDED OUTLETS (TO EXISTING CIRCUITS), LAMPHOLDERS LIGHTS AND YARD LIGHTING OR TEMPORARY PROPERTY OWNER(S) NAME: 1. Receptacles/Outlets a. 1 - 5 Outlets (Inclusive), Total Fee b. 6 - 10 Outlets (Inclusive), Total Fee c. Over 10 Outlets (Every 10 outlets or fraction thereof will be an additional $20 added to the $33 above) 2. Light Fixtures/Lampholders a. 50 or Less (Inclusive), Total Fee b. 51-100 (Inclusive), Total Fee c. Over 100 (Every 100 or fraction thereof will be an additional $66 added to the $99 above) $22 $33 $33 plus $20 & up ADDRESS: CITY, STATE, ZIP: $66 $99 $99 plus $66 & up PHONE: ELECTRICAL CONTRACTOR: S C e_WrS G1 `C MOTORS, TRANSFORMERS, HEATING APPLIANCES AND OR APPLIANCES MISC. EQUIPMENT (Rating of Equipment; H.P., K.W., or K.V.A) 1. 3 - 5 2. 6 - 20 3. 21 - 50 4. 51- 100 5. Over 100 $66 each EMAIL ADDRESS: \ JOn n Sc h e UC i-2-0li . n $66 each $66 each ADDRESS: 608 Mr ,� er `-' 1 'e© $66 each $66 each REQUIRED FIRE WARNING, COMMUNICATIONS AND CONTROL SYSTEMS EMERGENCY CITY, STATE, ZIP: KtLytii. "BO 1. a. Up to 50 Devices, Total Fee b. 51- 100 Devices, Total Fee c. 101- 200 Devices, Total Fee d. 201- 300 Devices, Total Fee e. 301- 500 Devices, Total Fee f. Over 500 Devices, Total Fee 2. Each Control Panel, Standby Power Panel, or Similar Main Piece of Control Equipment $35 $99 $132 $166 $196 PHONE:3(0 372— G 65-9- BUSINESS LICENSE NO: U' C f/ O'c9 O STATE LICENSE NO: 6/1(373 $35 each TYPE OF BUILDING: SERVICE PANELS/SUBPANELS (INCLUDING BREAKERS) AMP. and Voltage Ratings of Service Entrance or Conductors, Services Switches or Circuit Breakers or Switchboard Sections 1. 200 AMP or Less @ 600V or Less 2. 201- 600 AMP @ 600V or Less 3. Over 600 AMP @ 600V or Less 4. Over 600V Rating 5. Temporary Power Pole $5S et NO. OF STORIES: NO. OF METERS: $55 NO. OF FAMILIES: ' $55 $55 DATE ISSUED: Q ( Cx `� $43 MISCELLANEOUS $33 ISSUED BY: --lik_ SUPPLEMENTAL PERMIT FEE $17 ISSUANCE FEE $60 PERMIT NO: `"f - J►D/q5'' I U ( I ) TOTAL FEE I hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. No person shall be allowed to perform work under this permit in violation of the labor code of the State of California. I further state that I am properly licensed as required by Section 7031.5 of the State License Business and Professional Code (or claim exemption under Section 7044). ure of Contractor f...\application\electric 9/1/13.xlsx rev 8/31/13 Signature of Owner (If Owner/Builder) City of Hermosa Beach Civic Center, 1315 Valley Drive, Hermosa Beach, California 90254-3884 NOTICE! ALL ELECTRIC SERVICE UPGRADES, SOLAR PANELS, OR NEW SERVICE FOR NEW HOMES MUST BE APPROVED BY SOUTHERN CALIFORNIA EDISON FIRST BEFORE PERMIT WILL BE FINALED! PLEASE CONTACT : Ryan Barfield 310-783-9311 Please contact Public Works Department at (310) 318-0214 if work is going to be done in the public right of way (sidewalk or street). F:IB951CDICD Temp Files/sce notice 6/11/12