HomeMy Public PortalAbout4962 SERENO DR_Electrical__ reweesC- cw.�ee It/Ta APPLICATION FOR ELECTRICAL PERMIT
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BUILDIN ND SAFETY DIV1910N 1
FOR APPLICANT To nu In JOB
New Residential Bldgs &Pools
EACH NO FEE ADDRESS
1 &2 Finaily Sq Ft $ — $ LOCALITY
Multi family Sq Ft NEARCROSEST
Residential Swimming Pools OWNER OR
FIRM NAME
Outlets Light, Switch& Receptacle MAIL
First 20 O ADDRESS 6a N C)
Additional 4 Tel No g2j?46—Q6 AD
PLAN CHECK
Lighting Fixtures APPLICANT
First 20 ADDRESS
Additional
CITY Tel No
Fixed Appliances Not Over 1 HP PERMITAPPLICANT
Range_ Heater_ D W ADDRESS
Oven _ Dryer W M _
Top _ FAU W H CITY Tel No >
Hood Fen LICENSE OR o
Dlsp AC A— REG NUMBE Class
1 ACNNGw L.GG. TNw 1 RwvE wewG T.I.wrrL...TI.. O
Power Apparatus& Large Appliances .G ORDINANCES.....CT Ano wawa. To co L1.Lr i-
9 ^YP WITH c..T^NO .TATE uw. REGULATING W
Size&T pe HP, KW, KVA,or KVAR ELECTRICAL MIRING G N
Up to 1 Incl Z
T ....IF.T T 1 wY '..'K.11
C ..11 A. EG ANO/Gw
Over 7 t010 Incl CALIFORNIA• R THAT I A LG. wea.L.. Lau NTr A G STAT. or
Over 10 t0 SO Incl CALIFORNIA m THAT AN . LImwL wN.w GrN THE w.ov.
Over 60 to 1001 ncl PERMITEEw..lpltx�Lw Tr N
Over 100 31GNATU
Service; DISTRICT O OC ED BY
0 200 Amp Under 600 V
201 1000 Amp Under 600 V nPOWER
DATE IGNATURE
Over 1000 Amp or Over SOD V
Temp Power Pole&Appurtenances
Sign with One Branch Circuit
Additional Sign Brench Circuits ROUGH CONDUIT
(Other) WIRING
FIXTURES -
POWER AUTHORIZED
PERMIT FEE (Sub-Total) UTILITYCO NOTIFIED
PLAN CHECKING FEE (One Fourth Permit Fee) FINAL
PERMIT ISSUING FEE NOTES z.s s/ .uFs�o �77� GFZ
TOTAL FEE
PLAN CHECK VALIDATION CK MO CASH PERMIT CK' M O CASH
G L
t oao�No 2 2 0 2 0.5 0
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