HomeMy Public PortalAbout5028 AGNES AVE_Electrical_0 76A663 ;E806 468 APPLICATION FOR ELECTRICAL P MIT
■ "COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS ��
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUPERINTENDENT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
NO EACH FEE
RECE $ $ OWNER
P
]]yy MAIL
LIGHTS TOTAL FIRST 20 7 20 ADDRESS `/
SWITCH
OVER 2021 10 Z p CITY TEL NO 7 L'
ZLII
PLAN CHECK
-
LIGHTING TOTAL FIRST 20 Z 20 APPLICANT
FIXTURES OVER 20 10 ADDRESS
RANGE—DRYER—WTR HTR — CITY TEL NO
STA COOK_DISP �F A UL.,--' COIJTRAC TOR
SPACE HTR AIR CONO ADDRESS
CLOTHES WASH DISHWAS7_
FAN_OTHER 4. 1001 CITY TEL CLASS' d
LICENSE NO
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 T AT I AM PROPERLY REGISTERED AHD/OR
1 - 10 3 00 LICENSED AS REQUIRED BY LOS ANGELPER
OUNTY AND STATE OF
CALIFORNIA OR THAT M THE LEGAL OF AND INTEND TOCL
10 - 50 5 00 RESIDE N THE A O E OES GRIPEDSIDE N7IAL PROPERTY
U
SIGNATURE
50 - 100 10 00 OF PERMITTEE
100 - 500 15 00 U
DIST�ICT� Gtj S P O E PROCESSESIGN GAS
D Y
TUBE OR SIGN AND ONE CIRCUIT 3 00 '� Z
MARQUEE ADDITIONAL CIRCUITS 1 00 NOTES
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00 Q�
SERVICE OVER 600 VOLTS OR 200 AMP 5 00
TEMP SERVICE POLE &APPURTENANCES 3 00 APPROVALS DATE INSPECTOR S SIGNATURE
TEMP POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
PERMIT FEE (SUB TOTAL) WIRING
FIXTURES
PLAN CHECK FEE (507 PERMIT FEE)
POWER AUTHORIZED
PERMIT ISSUING FEE 2 00 O-L** UTILITY CO NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL /7
TOTAL FEE Q JO E H C ROOHAN
SUPERVISING ELEC ICAL ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M 0 CASH
LRC- 9 7 9 O r My 6 D 17-10-
EE
7.10NEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE