HomeMy Public PortalAbout5021 AGNES AVE_Electrical_0 76A8:6+4158 FOR ELECTRICAL P MIT
APPLICATION O
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
I BUILDING AND SAFETY DIVISION BUILDING
ADDRESS 2 I
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUPERINTENDENT OR BUILDINGLOCALITY �Yh
NEAREST
FOR APPLICANT TO FILL IN JCROSS ST 01
NO EACH FEE
$ $ OWNER
RECEPT
MAIL
LIGHT TOTAL FIRST 20 20 2o ADDRESS
SWITCH OVER 20 10 CITY TEL No,47
PLAN CHECK
LIGHTING �TOTAL FIRST 20 20 APPLICANT
FIXTURES OVER 20 10 ADDRESS
RANGE—DRYER—WTR HTR CITY TEL NO
STA COOK_DISP _F A U — COI4TRAC r0
SPACE HTR AIR COND
ADDRES L L
CLOTHES WASH _DISHWASH CITY TEL NO
FAN—OTHER 1 00 LICENSE IJO ,� �- CLASS
MOTORS 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 RED IRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO >_10 - 50 S 00 RESIDE IN THE ABOVE DESPED RESID TIAL PROPERTY CD
SIGNATURE U
50 - 100 10 00 OF PERMITTEE 0
100 - 500 15 00 C.)
DISICT NO G P ZON PROCESSED Y LLj
SIGN GAS SIGTN AND ONE CIRCUIT 3 00Q - e ff��
TUBE OR
MARQUEE ADDITIONAL CIRCUITS 1 00
NOTES
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 INSPECTORS SIGNATURE
TEMP POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
PERMIT FEE (SUB TOTAL) WIRING
FIXTURES
PLAN CHECK FEE (507 PERMIT FEE) n POWER AUTHORIZED
PERMIT ISSUING FEE 2 00 �" OU UTILITY CO NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL
TOTAL FEE Q JOSEPH C ROOHAN
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M 0CASH
7 7 9 6:8 DEC30 2 D 420~
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE