HomeMy Public PortalAbout5931 AGNES AVE_Electrical__ 76A663C CES068 12/75 APPLICATION FOR ELECTRICAL PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN 'OB
FResi,.d.,,,,Ity.,,l Bldgs &Pools
EA@H FEE ADDRESS
$ — $ LOCALITY
Sq Ft q Ft — NEAREST
4 ti Wok,
imming Pools CROSS ST
OWNER OR
FIRM NAME
Outlets Light Switch &Receptaclea� MAI L
First 20 9-0 0 o ADDRESS
Additional CITY P I No !
PLANCHECK zL
Lighting Fixtures APPLICANT
First 20 V ® ADDRESS
Additional
CITY Tel No
PERMIT
Fixed Appliances Not Over 1 HP APPLICANT
Range Heater_ D W ADDRESS
Oven Dryer W M
Top FAU W H CITY Tel No
Hood Fan LICENSE ORnr.
O REG NUMBER Class O
Dlsp A C
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
Power Apparatus& Large Appliances WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING 0
Size&T 1 ELECTRICAL WIRING V
Type HP KW KVA or KVAR LU
0.-
Up
Up to 1 Incl 00
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
Z
Over 1 to 10 InCI LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA ORTHAT 1 AM THE LEGAL OWNER OF THE ABOVE
Over 10 to 50 Incl DESCRIBED RESIDENTIAL PROPERTY
Over 50 to 100 Incl PERMITEE
Over 100 SIGNATUR
DISTRICT NO P OCE 9ED BY
Services___
0_200 Amp Under 600 V `-"'��
201 1000 Amp Under 600 V_ APPROVALS TE INSPECTOR S
Over 1000 Amp or Over 600 V
SIGNATURE
tF
MP POWER POLE
Temp Power Pole&Appurtenances DERSLAB WORK
Sign with One Branch Circuit
UGH CONDUIT
Additional Sign Branch Circuits �y
(Other) RING
TURES
WER AUTHORIZED
PERMIT FEE (Sub Total) ILITYCO NOTIFIED
PLAN CHECKING FEE (One Fourth Permit Fee) AL PERMIT ISSUING FEETOTALFEETES
PLAN CHECK VALIDATION CK MO CASH PERMIT VALIDATION CK MO CASH
b 4 U A t)
1�5,4� ,F c Ty
76A663 CE806 1 67 APPLICATION FOR ELECTRICAL PERMIT
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 L S
RECEPT j TOTAL No EACH FEE ^, �o
OUTLETS FIRST 20 $20 $ OWNER R0/7 .4!5,4 LC
LIGHT MAIL
SWITCH ADD L 10 ADDRESS
OVER 20
TOTAL FIRST 20 20 CITY TEL NO
LIGHTING 1 FIXTURES
FXTURES )( ADD Ltp CONTRACTOR DLIV( c LC /
OVER 20
RANGES DRYERS WTR HTRS 100D ADDRESS p7
GARB DISP STA COOK CITY TEL NCI .�
AUTO WASH STATE /�
SPACE HTRS BTA APPL 50 LICENSE NO (� t
MOTORS OVER NOT OVER H P DISTRI N G ZONE I P E BY
O 1 100 ���+j
1 s 150 INSPECTION RECORD
9 S 200
8 is 250 �-. /vS �
15 so 300 ,L r' 7' CL
a
50 100 500 OV
SIGNS NO TRANS
NO LAMPS GO
SERVICE O 600V NOT OVER 200A too 0 0
SERVICE O 600V OVER 200 A 200
SERVICE OVER 600V 500
OTHER (SEE COMPLETE FEE SCHEDULE)
r
PERMIT ISSUING FEE 200 00
SUPPLEMENTARY PERMIT ISSUING FEE too APPROVALS DATE INSPECTOR S SIGNATURE
TOTAL FEE
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION UNDERS LAB WORK
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ROUGH CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING WIRING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOV DESCR D RESIDENTIAL OP POWER
SIGNATURE UTILITY CO NOTIFIED ,1114w
OF PERMITTEE /� / p y11
/_
FINAL / Ile
-
u C R OHAN
S
CK MO CASH SUPERVIJOAPSING ELECTRICAL ENGINEER
94071 JUL 3 2 D 450- a