HomeMy Public PortalAbout4942 AGNES AVE_Electrical_0 '6A663 CE806 168 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER FUl7NG
BUILDING AND SAFETY DIVISION 76&6� !q VT
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUPERINTENDENT OF BUILDINGFOR APPLICANT TO FILL IN
NO EACH FEE d
$ $ OWNERWI7L�I'P� /✓
RECEPT MAIL
LIGHT TOTAL FIRST 20 20 ADDRESS r
SWITCH_ OVER 20 10 CITY 217-
( EL NO �L
PLAN CHECK/
_IGHTING �TOTAL FIRST 20 20 APPLICANT
1XTURES OVER 20 10 ADDRESS /
RANGEDRYERWTR HTR CITY TEL NO
STA COOK_DISP _F A U _ COIJTRAC TOR Ar
SPACE HTR AIR COND __/_ ADDRESS
ZLOTHES WASH DISHWASH CITY TEL NO
=ANOTHER 1 00 100LICENSE IJO CLASS
AOTORS TRANSFORMERS RATING
IND HEATERS ETC HP KW KVA I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING
0 - 1 1 00
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
1 - 10 3 00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO d
10 - 50 5 00 RESIDE IN THE ABOVE D SCRIPED RES ENTIAL PROPE TY
50 - 100 10 00 SIGNATURE
OF PERMITTEE a,
100 - 500 115 00 1 DISTRICT NO 'ORO P 14NEP OCESSED B G�
SIGN GAS SIGN AND ONE CIRCUIT 3 00 Q W
TUBE OR
d
MARQUEE ADDITIONAL CIRCUITS 1 00 NOTES N
Z
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00
SERVICE OVER 600 VOLTS OR 200 AMP 5 00
TEMP SERVICE POLE &APPURTENANCES 3 00 APPROVALS DATE INSPECTOR S SIGNATURE
TEMP POWER POLE I
UNDERSLAB WORK
ROUGH CONDUIT
PERMIT FEE (SUB TOTAL) WIRING
FIXTURES
PLAN CHECK FEE (507 PERMIT FEE) POWER AUTHORIZED
PERMIT ISSUING FEE 2 00 UTILITY CO NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1 00 1690 FINAL
TOTAL FEE loo JOSEPH C ROOHAN
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M G CASH
LiCo 5 5 5 5� &22 2 A 2 G O N Q
BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE