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APPLICATION AND
<br />ELECTRICAL PERMIT
<br />(TYPEWRITF O8 PRINT IN INK)
<br />o ! .,r"orroNrAANA
<br />20 CIVIC CENTER PLAZA
<br />834-4186
<br />(D
<br />C
<br />2a
<br />Io,
<br />?s
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<br />E Ses,oent,a E rnorsr',a tr c"..o",",to EACs rOTAL
<br />03
<br />JOB A
<br />IN
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<br />o2O.r. of C.rtori. sq Fro
<br />50
<br />50fufr,€CITY SIATE/ZIP
<br />50
<br />Each
<br />App.ova(, Facto.y WrGd t .r
<br />Ual
<br />500
<br />8!araya, ipacitl racawayt. undar ttoor 6uct,
<br />lrollay or 9lug-in Durrayr aa l0O'
<br />r0.00
<br />.50
<br />500
<br />100
<br />L'gnling sllndalds rnh ona lrlnp
<br />€ach addl trrur. on aam. aEnda.d
<br />7031 5,8u3i..sr^d Prol.s'o^s Cod. A.y oty or counvwn(h
<br />ali.', firr.@, d.ooll.h. d ..O., ..y !rErur., prs lo '$ ,$d
<br />rlch D..mlr ro nr.. .{Ed !r.r.m..r rh.r h€ '! rc.nsd
<br />. !.mr &q.ci3 lrr. .oorc.nr r. . cMl r{hy oi nor
<br />'*m, ol rh. proo.ry, o'6Y.mploy..sw h*.e6.3 rh. eL.06.
<br />I ..d rM *u.ruB 'r ml 'nr.nd.d d o,.6d td er.
<br />o4a8 r. .! o*E, ol rh. Foc..rY. .6.rcrll!|ry c@r&l',E sh r'..fi.d .o..!
<br />I td.!y .tlrn rh.r I .m .r.m9r lrm rh.Cdtreid's L'..n$ lrwl lh. t6ll*'
<br />C s""u- roaa
<br />Owil.r8dld.. D.d.r.rim
<br />;.qu.tih..opr,c..rtol
<br />r ro rh. orMad! ot rh. Co.tac
<br />7000r ol Ov's 3 ot lh. 8!!@t!.ndlo. r LEax Lrw lcn pw 9 l.@nErtng slh
<br />P.ol.&r6. Cod.l d rhat h. .a.r.mor iha b.!lllor rha alL!.d.r6prs A.y v'oL
<br />uo.l d S.crro. 7O3r 5 br rny
<br />nlo .lh.n i@ hund6d dollui l
<br />M.,nbn.nca P.nnn {a.nu.l)50.00
<br />Conrr.cror U.. Or y
<br />STAIE,ZIP
<br />.*
<br />Up lo aoo rm9., ir.. m.i.r
<br />o\/.r am am9a. pa. lnatar
<br />Ov.r l2m rnp3. p., m.l,
<br />tbftl.K
<br />75 00
<br />S€n6 .nd h'gh pol.nt.r 9.s tub! llghrrng 15 00
<br />S*mmrng pooL, lountarns, apar 3500
<br />gritcllDoard. iiolo. co.rlrol crtar o. !ub.!a.aL
<br />Etch
<br />r500
<br />Tam@aary conatruclion nralar lawrca pola
<br />Each di.tribulion 9olc
<br />r500
<br />3.00
<br />I h.rby .ftm tllr I .m rl...xd un L, trr rrtu.d3 ol Ch.pr., 9, D.ro. 3 o, lrr Eo.l!.ls .ndP.ol.ldl! Co4. ..ld my 1..^r. |t n lulr ldc. .nd .ll*l
<br />e
<br />200
<br />a00
<br />Tampo.ary conrtructlo^ lightino
<br />5o0 tampa or tar.O., 5O0 l.mp!
<br />T'm. cloct o, phoro aLclic call
<br />POWER aPP aAIUS: G.nc.don. molo.t
<br />tranalormar!, rlcirll.r., rnduanial h.ating,
<br />cootmo. or ba*ng cqu'pm. .nd olhc.
<br />p9aratu. .a lollorr:
<br />Up to and hchrdmg I HP, Kw. Kva
<br />Ov.r r r.d nol o\rcr l0 HP. l<W. KVA
<br />Ov.l l0 rnd nol o!., 50 HP, XW, XVA
<br />Ovar 50 rnd not ora, lm kP, Xll/. Xv
<br />Od lm .nd hot o,.. 5O0 HP. xw. Kva
<br />Ov.r 500 XP. XW. xvA
<br />fr.r-. coiT.aMr o.ca.ado.t
<br />I txr.by .fltrm hr I h.v. . c.arll..r. o, co.-nr ro ..lr'nre... o. . c.nr'{i. ol wo.r.. r Corn9.+
<br />paiadr . ary han@ E ar ro bacorft aubnar ro rrr wo.tar'. cdnp.nsnon L.wr ol c.hld.{
<br />tf.ifo. b AcCctrl:
<br />lt. .tr, ,n l,!C nr. C.nfE r. ol Er.mprM. vd $@rd o.c@ luq.cr to trr l\brrd'. Comp.n.
<br />!.r'on ,ovron. ol rll. l. bor cod.. yo! hln lo.lnsrn corhDly nri tlJ.h o.@ro.r. d rri.t o.m'r
<br />,r.r b. &.rn d r.vor.d
<br />gtoi rnrur.6 C.i,l.d coO, '! I'hd w{t rh. C!ry bu'ldr.e'nrC.ct'oa d.p.n6.nr
<br />I crrtty rhar n dE g.rioma.Ea ol tr w!.r td lh6 o.frrr B 64d. r st[rr Dr m!]or..Y
<br />O.a- Acarc&lls! I
<br />::":"W8
<br />Panarly F.€ l.h.n applc.blc)
<br />vrclrlon Fac (h.n'huh 435 0O)
<br />Plan Chacr fc€ lmrnrhuh !l50ol
<br />,PC ,d
<br />.,/ TOTAL ?lilll FCI ln'nrmum:3500)?
<br />E4a.do.l
<br />Thtt p.6'r ,trll.rpd. by lm'llrM..d bco@ noll lnd @d rl rh. woit allho.[ad by rht r..n'l I
<br />rol c@@rc.d srtun l8o d.yr 116 rh. drl' ol rtu p.mn d d wat auindl,rd by rn.t Fm't ,3
<br />!.o.nrhd or rb.^.ldxd .r ,y rm. .lr.r th. *d[ 'r c@n..c.d lor . g.iod ol 180 d.vr A mw
<br />Dam dtalr b. oDr.rmd n.3r b.lo. Mh rdt o t ,Eo.rm.ic.d
<br />AIilorit'. Da.L.do.t
<br />I cinnt nr.l I E6 ard rh'. .p9k to.r ..ld (ar. rn r lri aao. 6lo.inaro. € cqGr I .9.a. lo
<br />.mrlr wdtt .ll c'iy dd'urc65 .nd !ral. L*s Llrrn9 'rd60 conilrucl'o., r.d h.,.br ruiho.,,W 3c'ryb..r..upon rrbo.
<br />lD-?-?<olrE irtT io.
<br />PEnMII TSSUtD BY lS'! I
<br />BUILDING
<br />VER FIEO BY IS'O I
<br />\alo^lroN roFfcE usa oNLYr
<br />laccouNlrr-4r3)
<br />Dstibuionr 'l lnspeclor Copy 2.FleCopy 3 Frnanc€ Copy 4. Applicant CopY
<br />h
<br />APPLICANT FILI IN AREA BELOW
<br />i.r. llol.l.. Iol.l., Apl. So Fl
<br />20 00
<br />500
<br />Ftr. Sagnalrng Syrl.m Mhilnum l.€
<br />Oullei. imo*o o. h.al a6ntor
<br />300
<br />2.OO
<br />5.00
<br />r 0.00
<br />20.00
<br />30.00
<br />ao.00
<br />Subroral
<br />tJ lc
<br />-^ryBiiD /*ort^.
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