HomeMy Public PortalAbout4812 AGNES AVE_Electrical_7/31/1969_fixtures 7SA663 CES06 4 68_ APPLICATION FOR ELECTRICAL Pi4AIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEERBUILDING 7�
BUILDING AND SAFETY DIVISION }ADDRESS �5 ( VS
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUPERINTENDENT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST �J� 1
NO EACH FEE
S s OWNER O e .Q
RECEPT_ MAIL
LIGHT TOTAL FIRST 20 20 ADDRESSS(TA
SWITCH_ OVER 20 10 CITY TEL NO �
PLAN CHEClK
LIGHTING �TOTAL FIRST 20 20 APPLICANTFIXTURES OVER 20 10 ADDRESS k
RANGE_DRYER—WTR HTR — CITY TEL NO
STA COOK_DISP _F A U CO TRACTOR
SLC Y
SPACE HTR AIR COND t
ADDRESS
CLOTHES WASH —DISHWASH CITY TEL NO
FAN OTHER 1 00 Z 00LICENSE IJO CLASS
MOTORSTRANSFORMERS RATING
IND HEATERS ETC HP KW KVA 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
0 - 1 1 00 ELECTRICAL WIRING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
1 - 10 3 00 LICENSED AS RE0U IRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
10 - 50 Soo RESIDE IN THE ABOVE IPED RESIDENTIAL PROPERTY G
' CD
50 - 100 .1000 SIGNATURE
OF PERMIT - C�
100 - 500 15 00 V
TDIS!;:tI NO G P N PRO SED BY wURSIGN AND ONE CIRCUIT 3 00 y
177
Z_
MARQUEE ADDITIONAL CIRCUITS 1 00
NOTES
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00 2
SERVICE OVER 600 VOLTS OR 200 AMP 5 00 /
TEMP SERVICE POLE &APPURTENANCES 3 00 APPROVALS DATE INSPECTORSSIGNA URE
TEMP POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
WIRING
PERMIT FEE (SUB TOTAL)
FIXTURES
PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED
PERMIT ISSUING FEE 2 00 2 !!C�o UTILITY CO NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL
TOTAL FEE S OZ7 JOSEPH C ROOHAN"
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION CK M a CASH
? Ar,124OiFal JUL31 2 0 5QO- lq
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE