010754 (ELEC)APPLICANT NAME (L F. MI)
T
ADDRESS.
785`20 !HWY 111
!!CITY/CO��Mym�Uf�4Na�ITD�,Y,�`/STAA/T�,,E/ZIP ,�A C}'J(��,�i �Yvtt��tpOpppp
LA QtJli4T'A,, CA 7yy;�G:,'6:3, 00.00
JOB SITE ADDRESS/SPACE
WWY .III
7,0���,2£alaly�NITY/STAT
�rpp�����Ppp ��gg ��jj�}�qq�{��yynn��99.
�.Ir'f CQWINTA. ZIP CA -925000 0000
BOKPAG
41
PRC
01
C
18
yE
F
TWN
RNG
RVE
SE
l9
S
0
TRACT
000000
LOT
APPLICA►TTORt 1POR: 'C3.,ECTRICAL PEt3fM
TOTAL .
FEE
MOD
SB
TRACT NAME
OWNER
6E GAUNTRY ai
"CONTRACTOR -FIRM NAME
'�
ADDRESS
CIT\!CO MM UN I TY/STATE/Z I P
PHONE #
LICNC N
ARC/ENG FIRM NAME
ADDRESS
CITY/COMMUNITY/STATE/ZIP
1
PHONE N
LICNC N
USE OF PERMIT
PLANCHANGEA P -F TO 2.645
BLZON
a
�ptB
FSB_
ttt0
SSB
u 0
SSB
1c�
RSB
014)110
OFC ,
ZONE ORD #
p P, 5:31.9 7
1
LOT SZ
1 1
END
1
SIDE
0:000
APPI/PRMT 4 PS .DATE 01.0 7.5 4
T
y
yE
F
APPLICA►TTORt 1POR: 'C3.,ECTRICAL PEt3fM
TOTAL .
FEE
IIVJYC�.I VK J I.VYT
APPLICATION fOR ELECTRICAL PERMIT
' T• H 'I S x S A W P P L I C A I 1 0 'H 0 N L _Y
d.
e�
/ 1i �� fes• x.11 �
FORM 284-208,(2/81)
I
ee
010754
NO.
OPERATION
DATE
INSPECTOR
NO.
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
1
Set Back
33
Ventilation System
2
Ftgs & Frms
34
Plenums & Ducts
2A
Slab Grade
35
Furnace Comport.
3
Steel
36
Inlets & Outlets
4
Grout Blocks
37 Combustion Air
5
Bond Beams
38 Compressor
6
Roof Deck
39
Appl. Clearance
7
Framing
40
Fire Damper
8
Vents
41
Smoke Detection Device
9
Cainge Fire Wall
42 Commercial Hood
10
Fireplace P. L.
43
Final
WA
Fireplace T. 0.
[�
°o
ADDITIONAL INFORMATION
SEWAGE SYSTEM SIZE &. LOCATION
11 Exterior Lath
12 Internal Lath
12A Drywall
13 Finish Grade
INSULATION Thick R
Value
7A Walls (Batts)
12B Ceiling (Botts)
12C Ceiling (Blown)
14 Final
15 Ground Plumb
16 Water Piping
17 Rough Plumb
18 Vents
19 Sewage Disposal
20 Sewer
21 Water Heater
22 Water Softener
23 Water Service
24 Gas Test
25
Final
Tank Pit L. Line
REAR OF PROPERTY LINE
ELECTRICAL APPROVALS
P/L
P/
26 Power Pole
27 Conduit
28 Service Entrance
29 Wiring
29A Grounding Wire
29B Bonding
30 Fixtures
31 Service
32 Final
STREET NAME