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HomeMy Public PortalAbout9030 ACASO DR_Electrical_11/25/1969_fixtures 76A663-5E80415 3-69 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER // BUILDING AND SAFETY DIVISION TNEARES1 � �� , cp 01, JOHN A. LAMBIE, COUNTY ENGINEER o COLEMAN W..JENKINS, SUPERINTENDENT OF BUILDINY �yti FOR APPLICANT TO FILL IN . NO. EACH FEE $ $ OWNER ✓ RECEIPT. MAIL LIGHT TOTAL FIRST 2017 ,20 ADDRESS CITY TEL.NO. SWITCH 17 OVER 20 .10 PLAN CHECK LIGHTING LiL TAL FIRST 20 ,20 C APPLICANT FIXTURES OVER 20 ,10 ADDRESS RANGE_DRYER_WTR. HTR. CITY TEL.NO. STA. COOK DISP. _F.A.U._ CONTRACTOR �/ (✓p�l� SPACE HTR.—AIR COND. ADDRESS CLOTHES WASH. [_DISHWASH. CITY - /r-arm✓ TEL.NO. LICENSE N0. CLASS. FAN-/—OTHER 1.00 MOTORS,TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION IND. HEATERS, ETC. HP. KW. KVA. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. 0 - 1 1.00 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF 1 - 10 3.00 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO a RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. Q 10 — 50 5.00 U SIGNATURE � 50 - 100 10,00 OF PERMITTEE O 100 - 500 15.00 DISTRICT NO. GROUP ZONE PROCESSED BY V c7lF a SIGN,GAS SIGN AND ONE CIRCUIT 3.00 N TUBE, OR Z MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES:/ ►� Pj o , ' a�rt,'�,SC-17 q% SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 6J " f L"jr/c"p SERVICE OVER 600 VOLTS OR 200 AMP 5.00 TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE 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 �.A UTILIT CO.NOTIFIED y (� �' y SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL TOTAL FEE JOSEPH C. ROOHAN 9 SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CAS I � 6c"70' kX25 2 D 1 1.20{ SEE BACK OF APPLICATION FOR COMPLETF. FEE SCHEDULE