HomeMy Public PortalAbout5436 ACACIA ST_Electrical_7/18/1967_outlets 76A663-CE8061-67 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS C. G> 4
JOHN A LAMBIE, COUNTY ENGINEER r'
COLEMAN W JENKINS, SUPERINTENDENT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST �j A (✓(/
RECEPT TOTAL NO EACH FEE �J ' �Y /�-
1I OUTLETS FIRST 20 $ 20 $ OWNER O h J
LIGHT T ) MAIL
SWITCH ._JC ADD L 1O ADDRESS
OVER 20
1 TOTAL FIRST 20 20 CITY TEL--,NO
LIGHTING l FIXTURES
FIXTURES 1 ADD L 1O CONTRACTOR — •- /_�"'
OVER 20 1 �
RANGES DRYERS WTR HTRS 100 ADDRESS / � of
GARB DISP STA COOK ,� f
CITY J �✓(,1 TEL NO Q/r
DISHWASH AUTO-WASH STATE
SPACE HTRS STA APPL 80 LICENSE NO
MOTORS OVER NOT OVER HP DI$15IC�Tj •0,�.{P P S D B
O 1 1 00 .L� (%
1 s 150 INSPECTION RECORD
S B 200
8 15 250
15 50 1 13 00 d
50 100 500 0
SIGNS NO TRANS
NO LAMPS 0
SERVICE 0 600V-NoT OVER 200A 1001 rW
SERVICE 0 600V OVER 200 A 200 n
N
SERVICE OVER 600V 500
OTHER (SEE COMPLETE FEE SCHEDULE)
i
PERMIT ISSUING FEE 200
SUPPLEMENTARY PERMIT ISSUING FEE 100 APPROVALS DATE INSPECTOR'S SIGNATURIK
TOTAL FEE $ �0
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION UNDERSLAB WORK
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ROUGH CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING A {//�/1 WIRING
I HEREBY CERTIFY THAT I AM ROPERLY REGISTERED'AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COU TY AND STATE OF
CALIFORNIA OR THAT I AMf TME�LEGAL OWNE OF�ANDINTEND TO POWER
RESIDE IN THE ABOVE DSC IBED RESIDENT_AL PROP
SIGNATURE ./(�/AUTILITY CO NOTIFIED
OF PERMITTEE v 14 p//B�vv
FINAL �7 (!
/VALIDATION JOSEPH C ROOAAN
1 SUPERVISING ELECTRICAL ENGINEER
CK iM0 CASH
LAS 9 6,6 6,-%0.. ,AUL 18 2 0 3.6 0
0