10730 APPLICANT TO FILL IN IN WITHIN WITHIN RED LINES - USE BALL POINT PEN ONLY
"HUI LOI NG PROJECT I DENTI FICATI ON PERMIT NUMBER
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ADDRESS•/0999 De&cA BJD BUILDING-ELECTRICAL-PLUMBING-MECHANICAL
10730
OWNERS
NEmares- w; PART- PLAN CHECK VALIDATION
�/��E Ilr DTV. ELECTRIC PERMIT FEE
Ie HONE
CONTRACTORS
NAM UTLETS-SWITCHES-RECEP 10.00/1.00
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IC.No. 3 aS0
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LIGHTING FIXTURES 10.00/1.00
ADDRESS DRa PP LIANCES-RESIDENTIAL 4.00
ADDRESS
(,t PNONE q_ -0'7L PANELS 10.00 DATE OF APPLICATION
ARCHITECT 20.00 PLAN CHECK FEE P.C.NO.
DR K"MAJ eat"c PANELS (OVER 200 AMP)
ENGINEER
LIC.No. C.-IZO{y SIGNS TRANS. 3.00
ARCH,OR ENG. SPECIALCIRCUIT 5,00 PERMIT VALIDATION
ADDREss
jSI S. zIP EMP.METER OR POLE INS. 20.00 ^
APPLICANT'S MOTORS SEE FEE SCH.
ADDRESS f►
A D Ao• &C SERVICE CHANGE 20.00 I
a o LICENSED CONTRACTORS DECLARATION
at v 1 hereby afllmt thin I ma licensed under provisions of Chapter 9 ISSUANCE DATE
y a u (co oulenaSe
ng with ction 7000)of Division 3 of the Business and BLDG. ELECT. PLG. MECH.
F N z Pud,sim.,Cod}•rvaq TylicensLie is in lull to n ❑ ❑ ❑
z a w,- Liccnscf/y�sss c.Number
o F w DateJ-i'••�-I-9Y3-Contractor
a y s BUILDING PERMIT
IS a,rea OWNER-BUILDER DECLARATION INFORMATION
Kam " MISC.- REFER TO ORD
VALUATION SIFT.
X g LL H 1 hereby affirm that I am exanpt from the Contractor's License
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