HomeMy Public PortalAbout5500 BALDWIN AVE_Electrical__ (2) 7A663-CE80612/7SAPPLICATION FOR ELECTRICAL PER T
' COUNTY OF LOS ANGELES _
DEPARTMENT OF COUNTY ENGINEERFNNEAREST
JOB
ADDRESS S�� r
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FI IN Y
1
New Residential Bldgs& Pools EACH NO. FEr
1 & 2-Family, Sq. Ft. $ .025 — $ T.
OR
Multi-family Sq. Ft. .02 — FIRM NAME
Aj-
Residential Swimming Pools 20.00 MAIL
ADDRESS
Outlets: Light,Switch & Receptacle CITY Tel.No.
First 20 .50 PLAN CHECK
Additional .30 APPLICANT
DDR ESS
Lighting Fixtures
First 20 � .50 CITY Tel.No.
Additional .30 PERMIT )
APPLICANT '
Fixed Appliances Not Over 1 HP D S
Range—HeaterrD.W._ 71 -
CIT5 �� Tel.No.
Oven=Dryer_W.M._ LICENSE OR "
LRTop _ FAU I W.H._ ` REG.NUMBER ,G Class.
Hood_ Fan ___
DIS 2.00 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
p._A.C. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
Power Apparatus& Large Appliances ELECTRICAL WIRING. i
Size& Type HP, KW, KVA, or KVAR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
Up t0 1 Incl. 2.00 1 CALIFORNIA OR THAI I AM THE LEGAL OWNER OF THE ABOVE
Over 1 to 10 Incl.
5.00 DESCRII'ED RESIDENTIAL PROPERTY.
LJ
Over 10 to 50 Incl. 10.00 PERMITEE
Over 50 to 100 Incl. 20.00
SIGNATURE
Over 100 30.00 DISTRICT N RO `SED Y
Services
W
0- 200 Amp. Under 600 V 12.50 IN CTOR'S
APPROVALS DATE SIGNATURE
201-.1000 Amp. Under 600 V 25.00 Z
Over 1000 Amp. or Over 600 V 50.00 TEMP.POWER POLE
UN DE RS LAB WORK
Temp. Power Pole &Appurtenances 10.00
Sign with One Branch Circuit 10.00 ROUGH CONDUIT
Additional Sign Branch Circuits 2.00 WIRING ���� ''- �•.
(Other)
FIXTURES
POWER AUTHORIZED
JF
TILITY CO.NOTIFIED
INAL
c
PERMIT FEE (Sub-Total) OTES
PLAN CHECKING FEE (One-Fourth Permit Fee)
PERMIT ISSUING FEE $6.00
TOTAL FEE
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION cK. MO. CASH
2 5 6 C-MAY 12 2 0 2 2,5 0 At6
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE