HomeMy Public PortalAbout5928 AGNES AVE_Electrical__ 76A663C- CE8068 12,76 APPLICATION FOR ELECTRICAL PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN JOB �`,
Fedmential Bldgs.& Pools
EACH NO. FEE ADDRESS ., Z �• ! � r,'
aily Sq. Ft. $ — $ LOCALITYily Sq. Ft. — NEARESTal Swimming Pools CROSS ST.OWNER OR
FIRM NAMEht, Switch& Receptacle MAIL
ADDRESSal CITY est (�C Tel. No.
PLAN CHECK
APPLICANT
Lighting Fixtures 7
First 20 ADDRESS
Additional
CITY Tel. No.
PERMIT
Fixed Appliances Not Over 1 HP APPLICANT r 'ry, >T�,� OA
'�
Range Heater_ D.W.
ADDRESS � ��(,e^—` �47
Oven Dryer W.M. _
Top FAU W.H. CITY I 'C-Akl Cor Tel. No.
Hood Fan LICENSE ORo
Disp. A.C.
REG. NUMBER Z__ Class..
�
I HEREBY ACKNOWLEDGE THAT I HAVE-READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY U
Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING u.l
Size&Type HP, KW, KVA,or KVAR ELECTRICAL WIRING. N
Up to 1 Incl.
I HEREBY CERTIFY THAT I AM PROPERLY REf. ERED AND/OR
Over 1 to 10 Incl. LICENSED AS REQUIRED BY LOS ANGELES C UN AND STATE OF
CALIFORNIA OR THAT I TH EG L N OF THE ABOVE
Over 10 to 50 Incl. DESCRIBED RESIDENT. P P
Over 50 to 100 Incl. PERMITEE
Over 100 SIGNATURE
DISTRICT N ESS Y
Services '5i n� /
0-200 Amp. Under 600 V
201 - 1000 Amp. Under 600 VAPPROVALS AT INSPECTOR'S
Over 1000 Amp.or Over 600 V SIGNATURE
TEMP. POWER POLE 2,47,7
Temp. Power Pole&Appurtenances UNDERSLAB WORK
Sign with One Branch Circuit
Additional Sign Branch Circuits ROUGH CONDUIT
(Other) WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FEE (Sub-Total) L UTILITY CO.NOTIFIED
PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL
PERMIT ISSUING FEE \
NOTES
TOTAL FEE �� I
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
8 5 8 DEC 22 2 u 1 2.0 0
76A663C- CE806B 12,75 . APPLICATION FOR ELECTRICAL PERMIT
BUILDING ND SAFETY DIVISION 2 4?'/V
FOR APPLICANT TO FILL IN JOB
EACH NO. FEE ADDRESS
FResidential Bldgs.&Pools C,
Sq. Ft. $ — $ LOCALITY
q. Ft. — NEAREST
CROSS ST.
Residential Swimming Pools OWNER OR
FIRM NAME
Outlets: Light, Switch &Receptacle AIL
First 20 V d ADDRESS
Additibnal CITY Tel. No.
PLAN CHECK
Lighting Fixtures APPLICANT
First 20 ADDRESS
Additional CITY Tel.
PERMIT
Fixed Appliances Not Over 1 HP APPLICAN
Range HeaterD.W. ADDRESS
Oven Dryer W.M. _—
Top FAU W.H. CITY Tel. No.
Fan1qSr. OR
14Sd
Hood _ ���—� /7 D REG. NUMBER � Class. p
Disp. � A.C. / v
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT,THE ABOVE IS CORRECT AND AGREE TO COMPLY
Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING O
Size&Type HP, KW, KVA,Or KVAR ELECTRICAL WIRING. V
w
n..
Up to 1 Incl. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR N
Over 1 to 10 Incl. LICENSED AS REQUIRED By LOS ANGELES COUNTY AND STATE OF
z
rRR
NIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
Over 10 to 50 Incl. ED RESIDENTIAL PROP RTY.
Over 50 to 100 Incl. TEE o
Over 100 TURE
CT NO. O SSE
Services 6 �y
0-200 Amp. Under 600 V �f
201 - 1000 Amp. Under 600 V PPROVALS DATE INSPECTOR'S
Over 1000 Amp,or Over 600 V
SIGNATURE
POWER POLE
Temp. Power Pole&Appurtenances SLAB WORKSign with One Branch Circuit
CONDUITAdditional Sign Branch Circuits(Other) ES AUTHORIZED
PERMIT FEE (Sub-Total) UTILITY CO.NOTIFIED �Q ,
PLAN CHECKING FEE o (One-Fourth Permit Fee) FINAL 77
PERMIT ISSUING FEE
NOTES
TOTAL FEE
- 5
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK M.O. CASH
1 8 3 jAN l 1 2 U 4 0.7 5 s
1 .P ��