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<br /> CITY OF SOUTI-AN: FRANCISCO
<br /> BUILDING INS • ION DIVISION ,
<br /> 400 Grand Avenue, South San Fra i. , CA 94080 Phone 877 -8545
<br /> APPLICATION FOR ELzcTRICAL PERMIT
<br /> Permit EA. — $15.00 Supplement $4.50 QTY AP FEE Name
<br /> See Table #3B Nat. Elec. Code for specific t$44,01;---Z-Y, ' o= Address ff
<br /> �
<br /> details. — Ordinance No 1072 -89
<br /> t ��� w z � %
<br /> SYSTEM FEE SCHEDULE o City �
<br /> g �� 8
<br /> T el N o. t� > n
<br /> New Residential:
<br /> Name y -, / 4
<br /> New Multi Family $0.03 per sq. ft. - ,
<br /> Address ress , y T
<br /> New Single Family $0.035 per sq. ft. 14t 4
<br /> Other types of residential occupancies & a City ,',`, , t 1
<br /> alterations — Unit Fee Schedule ; Tel No " ' g
<br /> �
<br /> Swimming Pools .....$30.00 � o o Z State License No. „ ,-i "
<br /> Carn C Expositions City Bus. Lie_ No. 5 g4, ,
<br /> Electrical Generators & Rides ....... $15.00 ea.
<br /> Display lighting for rides ..... ..... ..... $ 4.50 ea. A WORKMAN'S COMPENSATION INFORMATION w
<br /> In conformity with the provisions of Sec. 3800 of the Labo l
<br /> System & Booth lighting $ 4.50 ea. Code of the state of Calif. each applicant shall file wit �
<br /> Permanently installed rides eto: ea.
<br /> the Building Inspector the certificate designated in (1) belo
<br /> use Unit Fee Schedule • , , . � e4' or shall sign item (2) whichever is applicable. b
<br /> _ (1) Certificate (or exact or duplicate copy) of Workmen 'a , 4r
<br /> Temp Power $15 ea. Compensation Ins. issued by an admitted insurer. '
<br /> Temp Lighting/Outlets .. ..........: $ 7.50 ea. • t f I certify that in the performance of the work fo $
<br /> UNIT FEE SCHEDULE wh h this permit is issued that I shall not employ any per p "
<br /> son in any manner so as to become subject to th k t
<br /> Outlets -- Plu s, Switches, Controllers � £ Workmen's Compensation Laws of Calif. s�� ; V"
<br /> First 20 .. ... ..... $ .75 ea. R i
<br /> Additional ... .. ... ........ $ .45 ea. roNED: ' .
<br /> (5 ft. or fraction of multi- outlet assy. is one outlet) x b acknowledge that I have read this appiication�
<br /> and state that the above i s correct and agree to complyt 4 ;"
<br /> Fixtures —First 20 $ .75 ea. with all City Ordinances and State Laws regulating buildin., s�"
<br /> construction.
<br /> Additional .. $ 45 ea. 4
<br /> Appliances Residential $ 3.00 ea. 1 / ,, % �( /t
<br /> / Policy No. , �. - , I
<br /> Non Residential Less than 1 hp. .........$ 3.00 ea. / SO
<br /> less than 1 kw:.... $ 2.00 ea. c
<br /> Expiration Date
<br /> less than 1 kva. . .....$ 2.00 ea. L >
<br /> Power Apparatus: --- �
<br /> (hp) (kw) (kva) (kvar) $ a T application is an Electric Permit when properl s
<br /> Up to and including 9 $ 3.00 ea. if y filled out, signed and validated for the correct fee In -q
<br /> • � the validation space. Permission is therefore granted ;
<br /> 10 tO 50 .... $15.00 ea. to do such work as indicated in this application in ac ,.
<br /> , 51 to 100 ... . $30.00 ea. • ' 1 cordance with and subject to all of the provisions o
<br /> 100 + $45.00 ea: the Electric Code of South San Francisco and ai
<br /> t related laws. Renew once at full fee. ' = .
<br /> *Note: Multi - motor equipment -- use sum of • 'r Th perm becomes null and void if work is not com
<br /> combined rating. Fees include all related Control menced within 18 0 days f rom th d ate of issuance, o "<'
<br /> equipment. • 4, if work is suspended at any time for more than 18®
<br /> Busways 100 ft. or fraction ....$ 4.50 ea. ';',,,::/.:P.,10,' ` days, or if any work is done in violation of any city or
<br /> y dinance or state law relating thereto. No materials ma , , 1'
<br /> Signs One circuit $15.00 ea. .T ,, i be stored on the street or public property without art ° -,:
<br /> Additional circuits for same sign .... . . $ 3.00 ea. encroachment permit from the City Engineer.
<br /> '
<br /> Services ` a Approved
<br /> less than 600 V @ 200 amps max .......$18.50 ea. / 4 -
<br /> less than 600 V @ 200 to 1000 amps ....$37.50 ea. o y By t '4 4 Date � �. e=
<br /> more than 600 V or over 100 amps $75.00 ea. Building inspector y<'
<br /> Apparatus not listed herein ... ....... .. $11.00 ea. -.Q. 2 ;`
<br /> RECEIPT # . r ,./ �' T Apparatus:
<br /> TOTAL PERMIT FEE s� .,
<br /> ,: 7 . � �
<br /> ; 414.44%itt hi
<br /> WHEN PROPERLY VALIDAThDTHIS IS YOUR PERMIT,
<br /> ',, WHITE — `Bldg. YELLOW App (oatstt PINK Inspector's Copy