HomeMy WebLinkAbout615ELECTRICAL PERMIT APPLICATION
City of Hermosa Beach - Community Development Department
NEW BRANCH CIRCUITS - LIGHTING OR GENERAL USE
AND DWELLING APPLIANCES
QTY
Amount
JOB ADDRESS:
.g
1. 15 or 20 AMP., 120V - 240V
a. 1-10 Circuits, Total Fee
Circuits, TotalFee
b. 11-40 More
c. 41 or MoreeCircuits, Total Fee
2. 15 or 20 AMP. @ 208V to 277V (Commercial)
3. All Other Lighting Circuits 600V or Less
$44
$89
$133
6 is �to d
JOB DESCRIPTION:
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49.,�, `(1
$22 each
$22 each
ADDED OUTLETS (TO EXISTING CIRCUITS), LAMPHOLDERS OR TEMPORARY
LIGHTS AND YARD LIGHTING
PROPERTY OWNER(S)
NAME:
kZ.i
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
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 $67 added to the $101 above)
$22
$34
$34 plus
$20 & up
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ADDR SS:
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CITY, STATE, ZIP:
$67
$101
$101 plus
$67 & up
PHONE:
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
$56
NO. OF STORIES:
NO. OF METERS:
@ 600V or Less
3.
$56
NO. OF FAMILIES:
Over 600 AMP @ 600V or Less
4. Over 600Rating
$56
$44
ATE ISSUED:
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Temporary Power Pole
$44
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MISCELLANEOUS
$34
ISSUED BY: ,(
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SUPPLEMENTAL PERMIT FEE
$17
ISSUANCE FEE
$61
PERMIT NO:
1(11' br2ge
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
• g this type of work will be complied with whether specified herein or not. No person shall be allowed to
• work unde this permit in violation of the labor code of the State of California. I further state that I am properly licensed as
r • uire. by Section 031.5 of the State License Business and Professional Code (or claim exemption under Section 7044).
ordinanc
perf
Signature of Contractor
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Signature of Owner (If Owner/Builder)