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� 1 <br /> CITY OF SOU ■ • ■ SAN FRANCISCO <br /> DEPARTMENT OF COMMUNITY DEVELOPMENT & ADMINISTRATION BUILDING INSPECTION DIVISION <br /> 400 Grand Avenue, South San Francisco, CA 94080 Phone 877 -8545 <br /> APPLICATION FOR ELECTRICAL PERMIT <br /> Permit EA.— $10°00 Supplement $3°00 OTY FEE Name ; . F f : - 0 <br /> See Table #3A '84 Nat. Elec. Code for specific w Address / <br /> details. --- Ordinance No. 1007 -86 . $10°00 z <br /> SYSTEM FEE SCHEDULE - o City, � f i 4 ¢ �' v - : O <br /> - Tel. No 30 <br /> m <br /> New Residential: <br /> — <br /> Name <br /> New Multi Family $.02 per sq. ft. <br /> New Single Family $.025 per sq. ft. o Address <br /> Other types of residential occupancies & Q City ;,.„2,1,„4.,,,i � £n• p ' g <br /> alterations — Unit Fee Schedule i- TeL No. � , , ti ` y; y <br /> Swimming Pools ............................ $20.00 _ 0 State License No. . ° <br /> Carnivals, Circuses, Expositions City Bus. Lic. No. . %' 2 <br /> Electrical Generators & Rides ...........$10.00 ea. <br /> g g $ 3.00 ea. WORKMAN'S COMPENSATION INFORMATION <br /> Display li htin for rides <br /> System & Booth lighting 3.00 ea. In conformity with the provisions of Sec. 3800 of the Labor <br /> r _ Code of the state of Calif. each applicant shall file with <br /> Permanently installed rides etc. ea. the Building Inspector the certificate designated in (1) below <br /> use Unit Fee Schedule or shall sign item (2) whichever is applicable. <br /> (1) Cert (or exact or duplicate copy) of Workmen's <br /> Temp Power $10 00 ea. , � 1. ,� C ompens a tion Ins, issued by an admitted insurer. <br /> Temp Lighting /Outlets , , ° . , , .... ° ....... $ 5.00 ea. (2) I certify that in the performance of the work for <br /> UNIT FEE SCHEDULE which this permit is issued that l shall not employ any per - <br /> son in any manner so as to become subject to the <br /> Outlets — Plugs, Switches, Controllers Workmen's Compensation Laws of Calif. <br /> First 20 .... ........ .: . $ .50 ea. �f A <br /> Additional ... , .... $ .30 ea. SIGNED: <br /> (5 ft. or fraction of multi - outlet assy. is one outlet) I hereby acknowledge that 1 have react this a pplication <br /> . and state that the above is correct and agree to comply <br /> Fixtures —First 20 $ .50 ea. with all City Ordinances and State Laws regulating building <br /> Additional . , , , <br /> $ .30 ea. construction. <br /> Appliances Residential , ° ... ... ....$ 2.00 ea. <br /> Policy No. <br /> Non Residential less than 1 hp. ........ ° $ 2.00 ea. <br /> less than 1 kw.......:.. $ 2.00 ea. <br /> Exp Date <br /> less than 1 kva. .. ... ...$ 2.00 ea. I <br /> Power Apparatus: — (hp) (kw) (kva) (kvar) This application is an Electric Permit when properly c <br /> Up to and including 9 $ 2.00 ea. filled out, signed and validated for the correct fee in C <br /> 10 to 50 $10 00 ea. " the validation space. Permission is therefore granted r <br /> to do such work as indicated in this application in ac- <br /> 51 to 100 ............... ° ..... , ... $20.00 ea. cordance with and subject to all of the provisions of Z <br /> 100+ .:........ :.. , , ... $30' 00 ea. the Electric Code of South San Francisco and all 17 <br /> related laws. Renew only once at full fee. T <br /> *Note: Multi -motor equipment — use sum of m <br /> Th perm becomes null and void if work is not com- 11 <br /> combined rating. Fees include all related control menced within 180 days from the date of issuance, or E <br /> equipment. if work is suspended at any time for more than 180 <br /> Busways 100 ft. or fraction $ 3.00 ea. days, or if any work is done in violation of any city or- Z <br /> dinance or state law relating thereto. No materials may O <br /> Signs One circuit ......... .... . .... '.... $10.00 ea. be stored on the street or public property without an -i <br /> Additional circuits for same sign $ 2.00 ea. encroachment permit from the City Engineer. <br /> Services Approved <br /> less than 600 V @ 200 amps max .......$12.50 ea. <br /> less than 600 V @ 200 to 1000 amps ....$25.00 ea. By ,,e _. Date ," <br /> more than 600 V or over 100 amps ......$50.00 ea. Building Inspector <br /> Apparatus not listed herein .. ° ° . ° .. ° ......$ 7.50 ea. <br /> RECEIPT # % Apparatus: �m <br /> TOTAL PERMIT FEE <br /> o <br /> Z •TI <br /> WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT. Q u <br /> r <br /> WHITE — Bldg. YELLOW — Applicant PINK Inspector's Copy f <br /> ) <br />