HomeMy Public PortalAbout6017 AGNES AVE_Electrical__ 76A663 CE806 10 69 A P P L I C A T I O A V �VR I C PERMIT
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COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING J,0171AIo GIVE
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY C Z�"'j��
FOR APPLICANT TO FILL IN cRoss sT O U U I /
PERT FEES
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ITEM NUMBER OWNE ,
EACH FEE MAIL �J�//
OUTLETS $ $ ADDRESS oil /!O ,S
LIGHTS RECEPT SW 10 /v
LIGHTING FIXTURES / 10 CI E Lc C/ TEL NO
ELEC RANG 1570 CLO DRYERS ELECTRICIAN / I L
WATER ADDRESS
ATERS 50
ELEC SPACE H DISHWASHERB CITY Tjgf TEL NO 'O
GARBAGE DISPOS4]t--*� AUT STATE
WASHERS STA COOKING UNITS 25 LICENSE NO 2=12—
MOTORS OVER INC H P I DISTRI O GROUP ZONE P CESSED Y
o— 1i2 25
.� a .�
1/2— 250 501 INSPECTION RECORD
2— 5 100
5— 15 150
15— 50 250
50-200 500
SIGNS NO TRANS
NO LAMPS
SERVICE O 600V too
SERVICE OVER 600V 500
MISC
WIRING PERMIT too OQ
FIXTURE PERMIT 100 O
SUPPLEMENTARY PERMIT 50
TOTAL FEE I's I (7
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT
ELECTRICAL WIRING WIRING
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 A THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL OPERTY POWER
I
SIGNATURE UTILITY CO NOTIFIED r 6r, /w/„//, D /f
OF PERMITTE
FINAL, yA
®P ATCASH ON f SURTHUERVISING
MO CEELECTRICAL ENGINEER
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