HomeMy Public PortalAbout4818 AGNES AVE_Electrical_4/9/1978_outlet, fixtures 77GA,66663C CE506113 12/75 APPLICATION R ELECTRICAL PERMIT
BUILDING AND SAFETY DIVISION
Q /� c
FOR APPLICANT TO FILL IN JOB
ADDRESS �v �V� G
New Residential Bldgs &Pools EACH NO FEE �� ��� /
V
1 &2 Finaily Sq Ft $ — $ LOCALITY
Multifamily Sq Ft — NEAREST ` ✓_v ��
CROSS ST
Residential Swimming Pools OWNER OR
FIRM NAME
Outlets Light Switch&Receptacle MAI L
First 20 �3 ADDRESS
Additional CITY Tel No
PLAN CHECK
APPLICANT `
Lighting Fixtures
First 20 ADDRESS
Additional
CITY Tel No
PERMIT ��
Fixed Appliances Not ve 1 HP APPLICANT ��� �} .��y v��--
Range_ Heaterk D W ADDRESS 76SS � ( v
Oven Dryer _ W M
Top FAU _ W H CITY��/'^■ �"� Tel No ��7
Hood Fan LICENSE OR -%&
q�C �_�� C
Dlsp A C ' REG NUMBER O Class C.2
ME E Y ACK EDG HA HAVE READ H A CAT ON
ANO AT HA HE A OV CO ECT AND AGREE O COM 0
Power Apparatus& Large Appliances W H A COUNTY O O NANCE AND ATE AW REG A NG V
Size&Type HP KW KVA or KVAR EC A W NG iy
a
Up to 1 Incl EBY CER NA AM RO ER Y EG FRED AND/OR N
Z
Over 1 to 10 Incl C N ED A REOU RED Y 0 ANGE E DUN Y A D ATE OF
CA FO A O TNA AM THE GA OWNER OF TH ABOVE
Over 10 to 50 Incl DE C B OR DENT>
Over 50 to 100 Incl PERMITEE
W
J
Over 100 SIGNATURE
DISTRICT NO PW
BY
Services
0 200 Amp Under 600 V
201 1000 Amp Under 600 V APPROVALS A INSPECTOR S
SIGNATURE
Over 1000 Amp or Over 600 V
TEMP POWER POLE
Temp Power Pole&Appurtenances UNDERSLAB WORK
Sign with One Branch Circuit
Additional Sign Branch Circuits ROUGH CONDUIT
(Other) WIRING
FIXTURES rp
POWER AUTHORIZED
PERMIT FEE (Sub Total) UTILITYCO NOTIFIED
PLAN CHECKING FEE (One Fourth Permit Fee) FINAL
PERMIT ISSUING FEE
TOTAL FEE NOTES
I— — n
d 14PNAN CJ:MCKWALIDATIONI 16-CK— M O'-- CASH PERMIT VALIDA K N CM O CASH
POLICYHOLDER ��c-"x-3"8 1.r'NAP � 2 � 1 12 U A
POLICY NUMBER r