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APPLICATION AND
<br />ELECTRICAL PERMIT
<br />ITYPFWRIIF OR PRINT IN INK)
<br />o Q;n:::rlrtAli^
<br />834-4186
<br />APPI-ICANT FIIL IN AREA BELOW
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<br />Izo
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<br />EACHD nes'oenl'ar O rnOusll,ar fic"..","'",
<br />8.., xot.l., uot.l., apt. sq Fr 03
<br />02
<br />50
<br />50 )6eta /4na ci$'^'"qL7ol
<br />a@_Ud
<br />qrt
<br />Btss tt44ii s+
<br />A\\\
<br />50
<br />Each 1 2000 so*
<br />l1 500 ao*App.oved Faclory Wtrsd lJnrl
<br />500
<br />Buiway3. special rac€waya, undo, lloor ducl
<br />rrottoy or pluc-in bir.wayr 6a l0o'
<br />E 10.00
<br />.50 ll- . 0tFir€ Signaling Sytlam Mrnimum le€
<br />ourl€i, smok6 0r hsal 36n50r
<br />500
<br />r00
<br />Lrghting Slandard6 wrlh One Lamp
<br />Each Add'l nnuro o.l Eama sEnda.d
<br />Orl,4rfd..Mi
<br />I h...Oy rtlm 0Et I m 6r@pl i.m lh6 Co.u&lor'! licss L& td UE roll i.!r..$n156
<br />7031.6, &lrlt!.rd Proleirr co(b any ory or cahry wh.h 6q{r.3. p.rm{ ro c4tral,
<br />ab..rmprov!,abfrolilh.o a9.tr.ny.tucrur.,pndlortsii{afts,.ltoBqu.tlh..pplic.nltd
<br />t,ch !.rfrr ro la . rgi.d ri.r.rmnr th.r h. r lr.nid po,@nr lo tE p.ovrtod ol n€ co.lt&_
<br />ra. ! L'c..!. l.* lch.Ba 0 (coolltr'^C wiln S..l'on 70OO) ol OMlm 3 ol Or B!3l\B Md
<br />P.d.&o.! Co<br o. rhrr h.6 o!@rt rhr.tm..d th. b.Il td ttr.lb!.d erdprb. Ary rloL'
<br />r'oi o, Sr.tro. 7031 .5 bry 6y .odd^r ld ! parmil $b|..l! lh€ !ppl6.nl lo a .lsl p.n lrv ol nol
<br />trlol. ih.n t@ hun&.d .rorrtlr I t500,
<br />fl s*o- zOrea l, .5 wr.. ol tho p'ol..ry, ol my .mploy6! nrh *.!.t .! ts, .ob co...
<br />D.nsio., u[ do rh. wk, md lh. nrucruE ir nor 6r.nd.d n ofi.6d lo $h
<br />[ ** r*., r..!m, or rh6r*L. ro crlr\dr!. qDr.r
<br />wy'?gb.\o,-,sn,_
<br />50 00Marnrenenc€ P€mii hnnua0
<br />q 1500
<br />35 00
<br />7500
<br />B5*Up ro 400 amps, p€r harar
<br />Ovs aoo smpl. pcr mcler
<br />Ov€r 1200 Bmpi, par m.lst
<br />Signs and h'gh pobnlial 9a3 lub6 lighling r500
<br />Swmming pools, lountain8, Bpas 35 00
<br />L r500 l{-t€o'
<br />S\rllchboad, molor conltol conlor or rubranoli
<br />E ch olA'O At-_-
<br />I 5
<br />3
<br />00
<br />00 D
<br />..<.?
<br />I
<br />Tsmporary consrrucnon metlr 3€Nlc6 polo
<br />€ach dEtriDuton oot.
<br />I h.6!y alii.m d[r I 16 lic.ru.d und.t rh. grovido! ol ch.pld 9. orvi.ioi 3 ol ltu 8ua..o .rd
<br />b.r-h!Cod., rldtiy lEai t '. id iorc...r.l.tt cr.
<br />Li:.irNo.- CLln--crrYtEfi!-
<br />O.i.- Cdr'xrs lsrg.l--
<br />Contr.cior Ut. Only
<br />aoosass
<br />CITY
<br />Tsmporery con3ltudron l€hling
<br />5O0 bmp! or 16$
<br />Ovff 5m rampr
<br />2 00
<br />00
<br />Tim. cloct or phoro eloclnc coll -1 3.00 bo-*
<br />I
<br />2.00
<br />500
<br />10 00
<br />20 00
<br />30'o0
<br />40.00
<br />lo -'
<br />FOWEA aPPABATUS: Gsnsralol!. molo,B,
<br />uan6lorm66, r€cil|€r, induslrEl hoalrng,
<br />coot(ing. or baking oquipmanl and olh€r
<br />apparatu! ea lolloi!.
<br />Up to and including 1 HP, Kw, Kva
<br />Ovor ! and nol ovo, 10 HP, Kw, KvA
<br />Ovor l0 and nol 0,61 50 HP, Kw. KvA
<br />Ovrr 50 rnd nol ov€r 100 HP. KW. KVA
<br />Ovs, 1OO and nol ov6r 5OO HP. KW. (vA
<br />Ov6r 500 HP. KW. XVA
<br />lvoaL-a Co.rTrtaadoll Dadaradoi
<br />lh.ratv rlttm rh.r Ih.s.citulE ro ot conla.r ro$llr3ur., o.c6rr E.r6 olWolt.r'!Comp.nrre hee. Cdtlad c!9y tr l&d *lh tE Clry butldrno n.p-ton rbp.nl1Et
<br />O.b E$,tLvdili.d 8y iSE l-
<br />, .trd mlkrng rhl' C.rttior. ol Ex.mplon. vou lhould b.c@. $br.<l lo lhs \ rod.t'3 Cnp..-
<br />sro.,@to. ol (h. Lrt . co.b, yo4r mu lo.lhwirncdndy *rh lch Ftut63d |trs p.ml
<br />rh.ll b. d€emd r.vord
<br />Frenalty F.€ twh6n apolrcabl.)
<br />vrolarion Fo€ {m'n'muh t35 0O)
<br />er< l5Plen Chocr F6s lm,n,mum 315.00)
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<br />.Jtl,'J521oz-tn t-1.)
<br />r000
<br />5rOTAL PEiIIT FEE {o ^ oum S35 00)
<br />IDAIE*/z,r tn(
<br />hpHor
<br />ll!! p.rrir aral arp.a by limtatd aod 6*ch.ull..d vod,l nE *ort .ulhon td b, thr! Frmil I
<br />hor .o.tldurld srhin 1@ d.Y3 no,n the d.ts o, th'r g.m.l d il wut !urnq..d bry lhi.9.m( .3
<br />.!r..<hd or.bu<ror!.d tl.r!y nft .lrt fi. *ort 6 co.nir.c.d tq. p.nod oa l8O d.Yr Alw
<br />!..D{ i.r b. O!l.i6d ni b.lo.. !!.n *O.t Crn b. '.Co.nru.6d
<br />^.a/aAirrc..,ora!..r,sq
<br />hal rh. abow 'nlsmsrD. r. cor..cr l.!roo ro
<br />rF! ro bu d'n! c6nrwrd, d'd h...bv &rtc
<br />:flN"ffit-
<br />ApDliclnf r D.cl.r.rlon
<br />I c.rtlv thrt I hav. r.ad thra ao![cano. ed abr. n
<br />cornoly sth d c'$ ddnft.! .id 361. rrws r.Ul
<br />u. .arras.nl.tw3 ol thB cnv ro..ror up6 lh6 abo
<br />PEnMrl rssuEo aY (sl! }_VERIFTCDBYlS'9 )- 4
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<br />65150Cb 331;E-sAIR ltl 5
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<br />rACCOUNlalr-413'
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<br />Distributionr 1 lnspsctor CoDy 2 File Copy 3 Financ€ Copv 4. Applicanl Copy
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