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HomeMy Public PortalAbout5921 AVON AVE_Electrical_9/14/1977_outlets 75A663 CE4306R 9/76 QPPUCAMN FOR ELECYMC AL PERNU COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER JOB ADDRESS / V V BUILDING AND SAFETY. DIVISION FOR APPLICANT.TO FILL IN j LOCALITY S��" �I New Residential Bldgs.:&Pools EACH NO, FEE NEAREST - 1 &2-Family,Sq. Ft. $ ' .025 — $ CROSS ST. WNER OR Multi-family Sq. Ft. 02• — FIRM NAM OE Residential Swimming Pools .20.00 MAIL •� 0 � / ADDRESS C� Outlets: Rec' Light' CITY - Tel.'No. � First 20 .50 ` 6 PLAN CHECK, Total No. Additional .30 APPLICANT ADDRESS Lighting Fixtures First 20 50 CITY ( Tel. No. � Total No.- "Zel� Additional 30 PERMIT APPLICANT l< �7 Fixed Appliances Not Over 1 HP ADDRESS Range—Heater—D.W._ CITYTel. No. Oven _Dryer—W.M._` `j LICENSE OR Top —FAU —W.H.- REG.NUMBER Class. Hood_Fon —Other— I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE Dlsp. _ Room Air Cond. 2'00 THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDIN- ANCESAND STATE LAWS REGULATING ELECTRICAL WIRING. Power Apparatus&Large Appliances Size&Type HP, KW, KVA,or KVARUIHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS 2.00 REQ RED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM � Up t0 1 Incl. THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. � Over 1 to 10 Incl 5.00 ,Cl C / Over 10 to 50 Incl 10.00 PERMITTEE Over 50 to 100 Inc. � 20.00 SIGNATURE Over 100 30.00cc DISTRICT PROCESSED BY Services r 0-200 Amp.Under 600 V 12.50 INSPECTOR'S v�D 201-1000 Amp.Under 600 V 25.00 APPROVALS DATE SIGNATURE Over 1000 Amp.or Ov6-600 V 50.00 TEMP. POWER POLE An �e Temp. Power Pole,&Appurtenances 10.00 UNDERSLAB WORK 1-14 r Sign with 10.00 ROUGH CONDUIT One Branch Circuit ' 2.00 WIRING Additional Sign Branch Circuits Misc.Conduits&Conductors 15.00 FIXTURES . Other(See Complete Fee Schedule) POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL- 2- PERMIT FEE (Sub-Total) NOTES S, {—j -- 1'T// PLAN CHECKING FEE (One-Fourth Permit Feel' I PERMIT ISSUING FEE $6.00. TOTAL FEE-,-,. _ 1��• PLAN CHECK•VALbATIbN'- r—bo 9N 11AA0T60rC PERMIT VALIDATION CK. M.O. CASH POLICY HOLDER: S' dp� Y ()gq a..:•>< �o iz ap : 2 _a .1 5.9 0 �..� .. SEE BO Ila, IUGR4�f�ORCOMPeTr HEDULE ©s