HomeMy Public PortalAbout5218 AGNES AVE_Electrical_0 76A663 0806 3 69e, c( 7-
APPLICATION FOR ,ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING7�
BUILDING AND SAFETY DIVISION ADDRESS eS
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JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUPERINTENDENT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST v
NO EACH FEE
$ $ OWNER '�J -
RECEIPT __l) MAIL
LIGHT TOTALADDRESS
CITY
FIRST 20 20 Q
SWITCHy OVER 20 1p CITY C'�I� TEL NO
PLAN CHECK
LIGHTING1 TOTAL FIRST 20 20 APPLICANT
FIXTURES J 3 OVER 20 10 ADDRESS
RANGE DRYER WTR HTR CITY TEL NO
STA COOK_DISP _F A U CONTRACTOR �/
SPACE HTR AIR COND ADDRESS /►' /
CLOTHES WASH DISHWASH CITY TEL NO
FAN OTHER 1 00 LICENSE NO CLASS
MOTORS TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
IND HEATERS ETC HP KW KVA AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING
0 - 1 1 00 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
ICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATEOF '
I - 10 3 00 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO a
RESIDE IN THE ABOVE S IESIDENTIAL OPERTY C
10 - 50 5 00 L
SIGNATURE
50 - 100 10DO OF PERMITTEE � Ilk
C
100 - 500 1500 DISTRICT NO GROUP ZONE PROCESSED BY U
W
SIGN GAS SIGN AND ONE CIRCUIT 3 00 0 r- N
TUBE OR ,Z
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
WIRING
PERMIT FEE (SUB TOTAL) FIXTURES
PLAN CHECK FEE (507 PERMIT FEE) POWER AUTHORIZED
PERMIT ISSUING FEE 2 00 UTILITY CO NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL
TOTAL FEEJOSEPH C ROOHAN
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK M D CASH PERMIT VALIDATION CK M O CASH
4 8c':_3 MAY 12 2 D 4.2 0M Ld
SEE BACK OF APPLICATION FOR COMPLETE FEF SCHEDULF