HomeMy Public PortalAbout5315, 5317 ARDEN DR_Electrical__ DBS-SA 9.55 APPLICATION FOR ELECTRIC ",IT
1
DBS-SA
DIVISION OF BUILDINGAND SAFETY
Deportment of County Engineer d
County of Los Angeles BUILDING I �`R /1�`0/ W�
WM.J. FOX. COUNTY ENGINEER ADDRESS A 7 ' 9116 D V 1/�
CASSATT D. GRIFFIN. SUPT of BUILDING LOCALITY C 0 9 6 U",C. Q
Ty
FOR APPLICANT TO FILL IN'
PERMIT FEES CROSS ST. ® �- V j'
NUMBER EACH FEE
OWNER �HE®Da � CIUC �
LIGHT OUTLETS f� hA�. �j
RECEPTACLES cS ADDRESS D J Jq_ L'l b'�R q�
WALL SWITCHES _ �.�, /J Q�'�`�V U
TOTAL OUTLETS _ Q� 5¢ $ CITY (l � Ir �//��Up�gT,EL. NO. "
ELEC.RANGES 25 ELECTRICIAN SA i 1 s OWN
�'�
ELEC. HEATERS 25 ADDRESS
KW EA CITY TEL. NO.
FIXTURES 5 1 LICENSE NO.
NUMBER OF LIGHT CIRCUITS - DISTRICT NO. GROUPI Z NFJ READY FOR INSPECTION
NUMBER OF RECEPTACLE CIRCUITS
MOTORS I
NUMBER I HORSEPOWER E INSPECTION RECORD
NEW MVD. HP OVER I FE
INC. EACH
1/2&LESS $ .25
1/z 2 .50
4
2 5 1.00
5 15 1.50,
15 50 2.50
50 200 5.AA0��0
MISC.
NO.SIGNS NO.TRANS. ,
NO.SIGNS NO. LAMPS
FOR EACH PERMIT: I
WIRING $1.00 j% (�
FIXTURES - $1.00 / U 6
SUPPLEMENTARY .50 I APPROVALS
TOTAL FEE $ ' J DATE INSPECTOR'S SIGNATURE
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION CONDUIT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY e �P
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATINGWIRING /
ELECTRICAL WIRING.
1 HEREBY CERTIFY THAT i AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REOUIRED BY LOS ANGELES COU TY AND STATE OF
CALIFORNIA OR THAT I AM TH LEGA W ER OF THE 04E POWER
DESCRIBED REST PER /
SIGNATURE ° UTILITY CO.NOTIFIED / 6// I
OF PERMITTE ° FINAL �I7{y
WILLIAM J. FOX. COUNTY ENGINEER VALIDATION A. C.VEIT,CHIEF ELECT. INSPECTOR
ACO 8 3 0 2 SEP 2 3 2 4.1 5