HomeMy WebLinkAbout2420 (2)I
ELECTRICAL PERMIT APPLICATION
City of Hermosa Beach - Community Development Department
NEW BRANCH CIRCUITS - LIGHTING OR GENERAL USE
AND DWELLING APPLIANCES
QTY
Amount
JOB ADDRESS:
if 0`�I we.i fie co•OA:
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
$44
$89
$133
JOB DESCRIPTION:
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$22 each
$22 each
ADDED OUTLETS (TO EXISTING CIRCUITS), LAMPHOLDERS OR TEMPORARY
LIGHTS AND YARD LIGHTING
PROPERTY OWNER(S) NAME:
/1,17 SPE A.
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 $34 above)
2. Light Fixtures/Lampholders
50 or Less (Inclusive), Total Fee
b. 51-100 (Inclusive), Total Fee
Over 100 (Every 100 or fraction thereof will
be an additional $67 added to the $101 above)
$22
$34
$34 plus
$20 & up
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ADDRESS:
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CITY, STATE, ZIP:
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$67
$101
$101 plus
$67 & up
PHONE: �� A473c.
31" I
ELECTRICAL CONTRACTOR:
MOTORS, TRANSFORMERS, HEATING APPLIANCES AND MISC. EQUIPMENT
OR APPLIANCES
(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
$67 each
EMAIL ADDRESS:
$67 each
$67 each
ADDRESS:
$67 each
$67 each
REQUIRED FIRE WARNING, COMMUNICATIONS AND
CONTROL SYSTEMS
EMERGENCY
CITY, STATE, ZIP:
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
$36
$65
$101
$134
$169
$199
PHONE:
BUSINESS LICENSE NO:
STATE LICENSE NO:
$36 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
Temporary Power Pole
$56
NO. OF STORIES:
NO. OF METERS:
$56
NO. OF FAMILIES:
$56
$56
DATE ISSUED: li5. /y
$44
MISCELLANEOUS $34
ISSUED BY:
SUPPLEMENTAL PERMIT FEE $17(ft:1
ISSUANCE FEE $61
PERMIT NO: �,^2('2
(�
TOTAL FEE
I hereby certify that I 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).
Signature of Contractor
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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
e'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:IB95ICDICD Temp Files/see notice 6/11/12
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