HomeMy Public PortalAbout5807 AGNES AVE_Electrical__ . APPLHCATION FOR PERS
]DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES ELECTRIC WM J FOX CHIEF ENGINEER
NAME DISTRICT NO GROUP /ZONE PERMIT NO
ADDRESS
RECEIVED BY READY FOR DATE ISSUED
U CITY TEL NO '/
w COUNTY // �I FIRST INSPECTION �f��T
W CERT NO 6 D Z c EXPIRES J
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
(DESCRIPTION OF WORD ADRESS
NUMBER OF OUTLETS ON CIRCUITS LOCALITY
LOCATION BY ROOMS
NEAREST
LIGHT OUTLETS ISW PLUGS FIXT CROSS ST
CIRCUIT A B C D E F G H lz NAMEaj, C
3 Z MAIL
ADDRESS
tl °
CITY TEL NO
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIF�TE OF QU LIFICATION
ELECTRICIAN
1 AM TH6 LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE
OWNER
�7p�
7�7(;
COA REMOlVS
J
Q
Z_
i7
O
TOTAL 3 L 3
NO OF OUTLETS $ a APPROVALS
NO OF FIXTURES $ 1 DATE INSPECTOR S NAME
NO OF MOTORS H P $ CONDUIT ,{� J��j
NO OF SIGNS TRANS $ WIRING . v J /
NO OF RANGES OR HEATERS ffi FIXTURES
MISCELLANEOUS $ POWER
PERMIT FEE ffi L !aa UTILITY CO NOTIFIED
TOTAL FEE FINAL