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Home My WebLink About1289 FOREST AVE; MULTI-PERMIT FILE; CB990267; Permit.. City of Carlsbad 01/20/1999 Electrical Permit Permit No:CB990267 Job Address: Permit Type: Parcel No: Reference #: Project Title: Applicant: Building Inspection Request Line (760) 438-3101 1289 FOREST AV CBAD ELEC 1561100800 UPGRADE ELEC SERVICE Lot#: 0 Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 01/20/1999 MDP 01/20/1999 01/20/1999 EDWARDS WILLIAM J&MARIAN R 1289 FOREST AVE CARLSBAD CA 5568 01/20/99 0001 01. 02 92008 Total Fees: $35.00 Electric Issue Fee Single Phase per AMP Three Phase per AMP Three Phase 480 Per AMP' Remodel/ Alteration per AM · Remodel Fee Temporary Service Fee Test Meter Fee Other Electrical Fees TOTAL PERMIT FEES Clearance: .00 .00 .00 0.00 0.00 $0.00 $0.00 $0.00 $0.00 $35.00 C-PRMT 35 ~ G(1 $35.00 NOTICE: Please take NOTI that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your ~ht to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capactiy changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any fees/exactions of which ou have reviousl been iven a NOTICE similar to this or as to which the statute of limitations has reviousl otherwise ex ired. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 , F-ERMIT APPLICATION FOR OFFICE USE ONLY "7 PLAN CHECK NO. 1J t,_ CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Patmas Dr., Carlsbad CA 92009 (760) 438-1161 EST.VAL._~~~~~~~~~ Plan Ck. Deposit--------- Validated By __________ _ Date'-------------~ ~ :t»JibJECT~FOSNA'!'fO I Z.? l El)rf'.s-f ·Ave • ~,c~~t:?~,-- Business Name (at this address) .--Address (include Bldg/Suite I) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total I of units Assessor's Parcel I Existing Use Proposed Use I of Bathrooms Name Address City State/Zip Telephone I Fax I Address City .State/Zlp Telephone I Name CON'l'U;CTORt· C9~ ·.i.i (Sec. 7031.6 Business and Professions Code: Any City or County which requires• permit to construct, 1lter, improve, demolish or repair any structure, prior to Its issuance, also requires the applicant for such permit· to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9, commending with Section 7000 of Divlsi!)n 3 of the Business and Professions Code) or th1t he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the 1pplic1nt to a clv_ll p!n1lty of not more than five hundred dollars ($6001). ·Name Address City State/Zip Telephone I State License I----------License Class----------City Business License I-------- Designer Name Address City Stete/Zip Telephone State License I 'e. WORKERS' COMPENSA'i'io Workers' Compensation Declaration: I hereby affirm under penelty of perjury one of the following declaretions: 0 I have and will maintain a certificate of consent to self-insure for workers' compensation. as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. . 0 I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit Is Issued. My worker's compensation insurance carrier and policy number are: · Insurance Company Policy No. Expiration Date _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1•1001 OR LESS) O CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which thia permit is lasued, I shall not employ any person in any manner so IS to become subject to the Work'ers' Compan11tion Lews of California. · • WARNING: Fllllunt to eecure wortc111' compenaltlon coverege 11 unlawful, end ahllll aubJect mn employer to c:rtmlnel penllltlu end clvll fine, up to one hundred thousand dollera 1$100,0001, In addition to the coat of compenntlon, damages II provided for In Section 3708 of the Labor code. lnt1111t and attorney's tu,. SIGNATURE DATE ~T"":oWr,iER~'8UltDER.D!cfMAT1~.. "' t~ ,..,.,~ I hereby affirm that I am exempt from the Contractor's License Law for the following reeson: 0 I, as owner of the property or my employees with wages as their sole compen11tion, will do the work and the structure Is not intended or ·offered for·sale (Sec. 7044, Business end Professions Coda: The Contractor's Llcansa Law does not apply to an owner of property who builds or Improves thereon, and who does such work himself or through his own employees, provided that auch improvements era not intended or offered for sale. If, however, the building or improvement Is sold within one year of completion, the owner-builder will have the burden of proving that he did not build oi improve for the purpose of sale). f'Sll" I, es owner of the property, 1m exclusively contracting with licensed contractors to construct the project (Sec. 7044, l;lusiness and Professions Coda: The ·tontractor's License Lew iloes not •PPIY to an owner of p(operty who builds or Improves thereon, and contracts for such projects with contractorlsl licensed pursuant to the Contractor's License Lew). 0 I am exempt under Section ------Business and Professions Code for thi1 reason: 1 . I personally plan to provide the major labor and materials for construction of the proposed property Improvement. 0 YES ONO 2. I (have I have not) signed an application for a building permit for the proposed· work. 3. I have contracted with the following persol) (firm) to provide the proposed construction (include name I address I phone number I contractor~ llca!1se number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name·/ address I phone number I contractors license number):. _____________________________________________ _ 5. I will provide soma of the work, but I have contracted . of work): _..,PROPERTY OWNER SIGNATURE COMPLm ~IS SECTtOF( FOiJ.fi the following persons to provide the work indicated (include 'name I address I phone number I type Is the applicant or future building occupa equired to submit a business plan, acutely hazardous m1terl1l1 registration form or risk management end prevention program under Sections 26605, 25533 r 25634 of the Presley-Tanner Hezardous Substance Account Act?-Q . YES O NO. · Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? O YES O NO Is the f~cility to be constructed within 1,000 feat of the outer boundery of a school site? 0 YES 0 . NO IF ANY OF THE ANSWERS. ARE YES. A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS :THE APPLICANT HAS MET OR·IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION"CONTROL DISTRICT. [8 I;. ,l'f'1'B_Uctf0fll.ENI?.. • ' . ·"'.;:.,;;.: • ..::~~. I hereby affirm that there is a cona~ructlon landing agency for the performance of the work for which t~is permit is issued (Sec. 3097(i) Civil Code). LENDER'S NAME ~AN'f~Tl~N ~~ , ~- 1 certify that I have read the application and state that the above information i. correct and that.the Information on the plans ls.accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the Citt of C1rtsb1d to enter upon the above me~tioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY· IN· CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required f~r ex~avations over 5'0" deep and demolition or construction of structures over.3 stories in height. EXPIRATION: Every permit l~uad by the Building Otfi~lal under the pr on of this Coda shall expire by limitation and become null and void if the building or work authorized.by such permit Is not cm encad.wthin 386 days fro the d e of such perf1!l1 or If the building or work authorized by such permit is suspended or abandoned at any time after the f 18 · lf.4.4 Uniform Building Coda). -"APPLICANT'S SIGNATURE DATE /-,zo -9 9 . PINK: Anance · City of Carlsbad Inspection Request For: 2/10/99 Permit# CB990267 Title: UPGRADE ELEC SERVICE Description: Type:ELEC Sub Type: Job Address: Suite: Location: 1289 FOREST AV Lot 0 O..PPLICANT : EDWARDS WILLIAM J&MARIAN R Owner: EDWARDS WILLIAM J&MARIAN R Remarks: PM PLEASE Total Time: Inspector Assignment: Phone: 7604341150 Inspector: ---- CD Description Requested By: BILL Entered By: CH'R~INE Act Comments (\ ,,}SY ~,:i ?&-----'~-~'l,.__~_uvv __ 33 Service Change/Upgrade ---------~ Inspection History Date Description Act I nsp Comments ~ 0 ~ "' :5 ill Q ~[ ::! 'z 0 u "' ... Q = ::, :!/1 ... z ~ z 0 s z ... .. ,. 0 u U) ic ... " "' i ![ JI I hereby affirm that I am llcensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and ett4/· ~ \ lie No Q..'7.55 C Class ____£')..l..___ __ _ I hereby atfirm that I am exempt !rom the Contrac· tor's License Law for the following reason (Sec 7031 5 Susmess and Professions COOe Any city or county wt11ch re-quires a p1Jrm1t 10 construct, alter. improve, demolish, or rerair any structure, prior to. 11s issuance also requires the ap- plicant for such permit to file a signed statement tMt he 1s licensed pursuant to the provisions of 1he Contractor's License law {Chapter 9 comrnenc,ng with Section 7000 of D1v1s1on 3 of the Business and Pro1essions Code) or that ,sex- empt therefrom and the tiasis for the alleged exemption. Any violation ot Section 7031.5 by an applicant for a permit sub-1ec!s the applicant to a civil penalty o1 not more than five hun- dred dollars ($500] L I. as owner of the property. or my employees with wages as th_e1r sole compensa1ion. will do the work, aM the struc- ture 1s not intended or offered for sale jSec. 7044. Business ond Professions Code: The Contractor's License Law does not apply to an owner ol property who builds or improves thereon and who_ does such work himself or through his own employees. provided that suet, 1mpr!Mlments are not intend· ed or otfered for sale. If. however. the building or improve- ment 1s sold w1th1n one year of completion .. the owner-builder will have the burden ol proving that he did not build or im- prove for the purpose of sale). D l,_as owner ol the property, am exclusively contracting wrth licensed contractors to construct the pro1ect (Sec. 7044, Business and Professions Code. The Contractor's License Law does not apply to an owner of property who builds or im- proves thereon, and who contracts for each proiects with a contractor(s) license pursuant to the Contractor's License Law). D As a homeowner I am improving my home, and the !ollow- ing cond1t1ons exist: 1. The work is being pertormed prior to sale 2 I have lived 1n my home !or twelve months prior to completion of this work. 3. I have not claimed this exemption during the last three years Cl lamexemptunderSec .B&P.C. for this reason------------- 0 I hereby a!lirm 1ha! I ha~e a cert,t,cate o! consent to sell·msure, or a certof,cate of Workers Compensation Insurance, or a cerM,ed copy 1'1ereot (Sec 3800. lat>or Code) POLICYNO ___ ___ -_______ l\ COMPAN, ~t& -~ I;=""<\ bl:..._eopy ,s foied with the c,ty 0 Cert1!1ed copy 1s hereby !urn1shed CERTIFICATE. OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed d the perm,t ,s tor one hundred dollars ($1001 or less! 0 I cert,ty that 1n the perlormar,ce 01 the won< !or wh,ch th,s perrmt ,s ,ssued. I shall not employ any person 1n any manr,er so as 10 become sub1ec1 to the Worllers' Compensation Laws ot Caiolom,a NOTICE TO A.PPLICANT II. alter makm~ th,s Ce11, 1,cate of Exemption. you should become sub1ec1 l'J the Worl<ers· Compensa1,on pro.is1ons al the labor Code. you must torthw1th comply with such prov,s,ons 01 111,s permit shall be deemed revoked 0 I hereby affirm triat there ,s a construct,on lendmg agency tor lhe performance ot the worl< 101 which th,s perm,t ,s ,ssued 1sec 3097. Civil Godel Lenders Name ___________ _ Lender·s Address----------- USE BALL POINT PEN ONLY & PRE~S HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT 1200 Elm, Carlsbad, California 92008-198~9) 438-55~ JOB A.DDRESS l~S~ AV~$T.,OATE OF AffLtCATION RO. , 8USINE$S LICENSE # i-/L VALUATION PERMIT NUMBER 17? f'.c:n ,e9,.\ CONTRACTORS PHONE• ZONE OWNER'S PHONE CciNTJ'IACTOR ~ -~ \..\t'.t .. ;\\ BLOG USE CODE l OWN"f:A'S'NAME 1.$1-Slf'\7 ~·.\\ \WH-~ LICENSE NO. PLAN I.D. # O~~~~;ILIN~O~:i CONTRACTOR'S AD~ ito.s ~OU.,~ BUILDING SQ. FOOTAGE Q. "l.SSlfO LtCE'NSE # STANDARD PLAN# LOT I BLOCK T SUSO! VISION l ASSESSOR PARCEL NO. OEStGNER DESCRIPTION Of-WQRK OE;SIQNER)l AO DRESS. ~~~~~~~~~~~~--'-:-'-~~~..--'~'-"-'------1 t:>~J~~+~ ~-.l. DESIGNEfl.'S.PH/ I F/P FLA ELEV OCC GP/ NO STORIES YO NO __ [ I I / EDU CENSUS TRACT GP LAND use PARKING SPACE RES UNITS GRADING f'.ERMIT ISSUED :~~~VELOPMENT cc LOAD FIRE SPA -4~~1!-la~ QTY_ I YO NO YO r,.,;Q vO NO ·· Ii s rf!i«l PLUMBING PERMIT -ISSUE .--, 5'7" / ;;_::.... II QTY MECHANICAL PERMIT· ISSUE SUMMARY/ACCOUNT NUMBER INSTALL FURN DUCTS VP TO 100,000 BTii) V BUILDING PERMIT 01-00-00-8220 SIGN PERMIT 01-00-00-8221 "' AOI l"UC-1"11 01-00-00-8806 01-00-00-8222 i::i i::l"'TDICAL 01-00-00-8223 ----- MECHANICAL 01-00-00-8224 EACH FIXTURE TRAP / -~---__o_vrn_100:o a BOILER/COMPRESSOR UP TO 3 tffl i=i..,...1~ vni::v" -~ ----so1_l_-Ef0COMPREsS0~P ·;, TOTAL PLUMB~ ) ;+ -----METAL FIREPLACEA. ,_,_,_,.,,, VENT FAN SINGLEy'U~ EACH BU!LDING SEWER EACH WATER HEATER AND/OR VENT r----------------;,- EACH GAS SYSTEM 1 TO 4 OUTLETS_ ~-·· s EACH GAS SYSTEM 5 OR MORE EACH INSTA~ .. ALTER. REPAIR WATER PIPE uno11 i::unui:: 01-00-00-8225 EACH VACUUM BREAKER WATER SOFTNER MECH EXHAUST - H 0/ CTS IVIUDILl:flUIYII: -------II I RELOCATION OF E F NAcEIHEATER MOBILEHDME PARK INSP __ _ EACH ROOF DRAIN (INSIDE\ 1'1.0l .., li''!I! I-------+ ---- _ SOLAR ___ _ 01-00-00-8...226. _ --------j ---+--1!----TOT~L ME STRONG MOTION 80-92-33-0519 ----- FIRE SPRINKLERS 01-00-00-8227 I PUBLIC FACILITIES FEE 32-00-00~_8923 BRIDGE FEE ---~ ------- TO T Al PLUMBING ___ __/) f O (} ELECTRICAL PERMIT -ISS~E .;-- NEW CONST EA AMP:swTilKR ----COLLECTORS . SCHOOL FEE -DISTRICT i 1 PH 3 PH STORAGE TANKS Carlsbad 80-92-21-0519 ~IST BLDG EA AMPiSWl-iBKR -----=-_ ROCK STORAGE ____ · Encin~ 80-92-22-0519 3 PH ;~ PUMP San Diegu1to 80-92-23-05~9 REMOOEL_A-~TER -~~l~CUIT ---= ~~-=-----=_ ~=~N CHECK FEE __ ---1 San M-~~ -80-92~~:0_519 _ t-~EMPPOL_~-j_Q_D_±~PS _ _ ____ __ ____ __ __ _ __ :_ __ _ PS _________ _____ _ I--------1---__ _ ____ _ __ _ TEMP OCCUPANCY 130 DAYS) I -------, --------------------. --I - - __l -TOTAL ELECTRICAL ---1 __ J ---~ --+--TOTAL SOLAR ----r ---TOTAL FEES PAYABLE I / 0 . ,l'-U f---- QTY. QTY. 'SOLAR -ISSUE , I PH '1:11_ -VE'()Af!EF!/LL __ YE)(Af!'INEDTHEGOMPI.IITEO "'Al'PLICAflPN ANQ i'l!!\M!_F~""-D<l ~~-· .· ·_._-.... ~~'''""'.t--·~ ..... ~;.. ... _ . _,;...tno.~il,i; . -·1m·-_ ·-_ F9I' °""_··--~l:if;V ~.Plff #£)4N.T'rOF PERJURY TH.AT Ai,.L [Nf'm™,b!tlON H~,fNCLUOfNG TH~ -r~ .... J'~ar'ldJMco~al)it , ffthlbutt;da{&J:)I~-,.·'·,' :tt' tio·~QRC(JN$TFIUC1)0N()F'" .\ -~·~_, ~/t~.A.NDOORRECTANDtFURl'K~Of_ RT1FYAN&'A;GAEelF~PEf1MtTIS ~~Y::"~·._~:::s,:~~i&'~ , p(~ , , , : ~'3,S10fllESwtHEGKT ',' ' ~~ ;F~~"f-Vv'ITTi'Al.L<;;ftY.PQUNTY AND-ST~'LAWSGOVERNfNG-:8UILf»OOCON~ ' ' 'It" rtmtewtel'ttMJ' 1S , , '',,,tor--..·. , '·;/'".":. ', -. '' '-~c;"Fij>!I; WKerl!~~1"0 -~ Oil NOL 1-AUlO AOOl;E lj) S,',YlijNPEMNIFY AkO -,, ....,;,,.;1 -QA TE '.KEEl'J!AII~-_ Tji~_m:::r.Sl!,\4 jyAINS1"'AUJJAIH"""5,NJUl)()MEt+ts; ~~ , --• · • -• • ;~ .; . / ;!If; -/ :"}~-~~:~_"'.:'< :~ -• -< .• -,,-.---~-;;!!:.,•h,,, ... -,"------.. , __ ,_,, . . 17'L(-/J) -·· - ~ LL > :. 0 a_ E ,"' I -0 0 "' c rn -~ o_ a_ <( I -"' ~., . e!n"' 0 "' "' "' "' "' <( I ~ .£ .; >- .; "' "' " 0 0: "' oi 0 ~ "' " C "' C LL C "' ~ "' 0 u "' a_ "' C ~ "" ;; INSPECTION TYPE DATE INSPECTOR BUILDING - FOUNDATION REINFORCED STEEL MASONRY GUNITE OR GROUT FLOOR & CEILING SUB FRAME SHEATHING FRAME EXTERIOR LATH lNSULATION INTERIOR LATH & DRYWALL PLUMBING SEWER AND BL/CO • PLUMBING UNDERGROUND PLUMBING TOP OUT TUB AND SHOWER PAN GAS TEST ELECTRICAL TEMPORARY POWER ELECTRIC UNDERGROUND ROUGH ELECTRIC ELECTRIC SERVICE BONDING G. F. I. -SMOKE DETECTOR MECHANICAL DUCT & PLEM., REF. PIPING HEAT -AIR COND. -SOLAR SYSTEMS VENTILATING SYSTEMS - CALL FOR FINAL INSPECTION WHEN All APPROPRIATE ITEMS ABOVE HA VE BEEN APPROVED. JOB SITE FINAL PLUMBING ELECTRICAL MECHANICAL .. -----GAS IU7".1 !~ c-DIYI BUILDING I i SPECIAL CONDITIONS CERT OF OCCUPANCY ISSUED ' ~::,-/7~ - FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES INSPECTION REQ IF INSPECTOR'S DATE CHECKED APPROVAL SOILS COMPLIANCE PRIOR TO FOUNDATION INSP STRUCTURAL CONCRETE OVER 2000 PSI PRESTRESSED CONCRETE POST TENSIONED -- CONCRETE FIELD WELDING HIGH STRENGTH . BOLTS SPECIAL MASONRY ' PILES CAISSONS ·-----·- ·-- -·i •• :i w <5!'" ':' :. : . _'-"':I'- ;-_-.-_-;,;._~~---' lt'.e :.:.~ -. ------ ---· --, ------·- ---- ) 7~--,,· C/ Applicant to complete numbered spaces only. Phone 7 29-1181 • Permit No. i. , ELECTRICAL PERMIT APPLICATION City of CARLSBAD, CALIFORNIA 92008 ••12..C JOa ADOJII CS9 /~.L, /;~ -~~> .. ,,~i~ ~ -; LOT HO, aLK I TUC T LltGAL I Qstc ATT ACHED SHtltT) 1 DUCII. OWNCflt • MAIL ADCftC99 ZIP PHONt 2 J:::/1L L / 1,,.,LI ;"'\ -, ~ COHTIIAC TOIi ! ., MAIL ADD,tESS PHON t 12.oog LICCNS[ NO, STATE CITY 3 t' ~--P!. ?--~ IA .v1:-AJ '/)fl. f). .,. -% -: :)._(J ' j -C'\~C_,.k' .,. --,· . ' t 'j AIIIICHITECT 0111 oJ.slGNU4 -, MAIL A00f1E:S9 4 PHONE ,~ 9-1 -:,7r,_cENSE NO, •r EMGIMEC" MAIL AOD"ESS PHON[ LICl:NSE NO, 5 , fl' COMP EN Sf TION INS CARR IER MAIL AOOIIIIE:SS 8JIIANCH 6 I -"--'RT IC /"ta{: " -USE o,-8UIL01NG '-I ~ 7 ,--;-, r: . . I ~RATION 8 Class of work: ONEW 0 ADDITION 0 REPAIR 9 Describe work: PERMIT FEES No. Each Fee SPECIAL CONDITIONS: ISSUANCE OF EACH PERMIT !). 0!1 • • NEW CONSTRUCTION, FOR EACH Al'PLICATION ACCEPTED BY PLANS CHECKED BY APPROV.ED,J'OR ISSUANCE BY AMPERES OF MAIN SERVICE, SWITCH, FUSE OR BREAKER 'fu 0 TE q-1&-,•I,.. NEW SERVICE ON EXISTING BLDG. &11-Nd~ FOR EA. AMPERE OF 1 w~~e~~ NOTICE IN MAIN SERVICE, SWITC' , 1,.1'1\ p THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-OR BREAKER I /O<J TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF AP CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A REMODEL, ALTERATION, NO CHANGE ~( '~I PERIOD OF 120 DAY::. AT ANY TIME AFTER WORK IS COM MENCED. IN SERVICE, FOR EA. AMPERE OF 'U I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS INCREASE )04 APPLICATION AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS ANO OROINANCE5. GO VERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT TEMP. SERVICE UP TO AND INCLUD· PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING ING 200 AMP. CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. J ,-() ~ TEMP. SERVICE OVER 200 AMP. )t-~,~ PER 100 -• atoNATUIU D, C:OHTIIACTOII OIi AUTHOlllllD AGt:NT (DATU "\ PERMIT FEE J) oC ....... T ... I\,. f'IIWWCfll ft~ OWHElt a utLDl:fl DATU WHEN rROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH INSPECTOR INSPECTION REPORTS DATE ITEM REMARKS INSPECTOR USE SPACE BELOW FOR NOTES, FOLLOW-UP, ETC. 5-18-76 Electric: O.K. Called in to G.&E. R. Green