HomeMy Public PortalAbout4817 AGNES AVE_Electrical_8/15/1977_elect panel 76AG63 CE 8 V9/76 APPLICATION F ELECT AL PERMIT
91 t COUNTY OF LOS ANGELES
01 DEPARTMENT OF COUNTY ENGINEER F
BUILDING AND SAFETY DIVISION i
FOR APPLICANT TO FILL IN Y f
New Residential Bldgs &Pools EACH NO FEE NEAREST
1 &2 Family Sq Ft $ 025 — $ OWNER CROSS ST
T
Multi family Sq Ft 02 — FIRM NAME
OR
Residential Swimming Pools 2000 MAIL
ADDRESS
Outlets Rec Light_Sw— CITY Tel No
First 20 50 PLAN CHECK
Total No Additional n 1 30 APPLICANT
1� ADDRESS 1
Lighting Fixtures First 20 50 1 CITY/10" Tel No F
IT
Total No Additional 30 APPLICANT \
Fixed Appliances Not Over 1 HP / ADDRESS
Range_Heater—D W 1 CITY Te No
Oven_Dryer_W M_ !
LICENSE OR
Top
If —W H REG NUMBER Class
Hood_Fan Other__ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
Disp — Room Air Cond ) 2 00 THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDIN
ANCES AND STATE LAWS REGULATING ELECTRICAL WIRING
i
Power Apparatus&Large Appliances
Size&iType HP KW KVA or KVAR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS
REQUIRED BY LOS ANGELES COUNTY AND STATE 0 CAL ORNIA OR THAT I AM
1. Lip to 1 Ind 2 00 THE LEGAL OWNER OF THE ABOVE DESCRIBED REST NTI PROPERTY
S 00
Over 1 to 10 Incl c 4
10 00 PERMITTEE 0Over 10 to 50 Incl
Over 50 to 100 Inc 2000 SIGNATUREV %)
Over 100 30 00cc
r DISTRICT NO P ED BY C
Sery ces
ay �
0 200 Amp'Under 600 V 12 50INS CTOR S U11201 1000 Amp Under 600 V
2500 APPROVALS DATE SIGNATURE Z
Over 1000 Amp or Over 600 V r 5000 TEMP POWER POLE
10 00 UNDERSLAB WORK 1
Temp Power Pole&Appurtenorces ROUGH CONDUIT r
Sign with One Branch Circuit 1000
200 WIRING
Additional Sign Branch Circuits
I 15 00 FIXTURES
Misc Conduits&Conductors
Other(See Complete Fee Schedule) POWER AUTHORIZED + t IL}
UTILITY Cd NOTIFIED
FINAL
PERMIT FEE (Sub Total) NOTES I
} H
PLAN CHECKING FEE (One Fourth Permit Fee) ° e f + i + 41 s
PERMIT ISSUING FEE $600 r 1 I h + T it
I
TOTAL FEE ' J �'� 1 I r ' * %H yea +
PLAN CHECK VALIDATION i CK M O CASH PERMIT VALIDATION, CK'�J r M O r r� CASH
r R1y
20 2�Aug 5 a�,�, X1.3 5 G �
r of
'SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE L I ®s