HomeMy Public PortalAbout9078ACASO DR_Electrical (2) `~9-66 APPLICATI&N alR� ELEC ICAL PERIIAIT
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C /OUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS d
JOHN A LAMBIE, COUNTY ENGINEER
COLEMAN W JENKINS, SUPERINTENDENT OF BUILDINGLOCALITY
NEAREST
�--+ FOR APPLICANT TO FILL IN cRoss ST �jlu.wrvwi�sl
RECEPT J1 TOTAL No EACH FEE
LIGHT l OUTLETS FIRST 20 $20 $ ! V/e) OWNER
J( MAIL b
SWITCH ADD L 10 ) ADDRESS
OVER 20
TOTAL FIRST 20 20 CITY ' TEL NO
LIGHTING 1 FIXTURES
FIXTURES 1 ADD L
OVER 20 10 CONTRACTOR
RANGES DRYERS WTR HTRS . 100. ADDRESS
GARB DISP STA COOK CITY TEL NO
DISHWASH AUTO-WASH STATE
SPACE HTRS STA APPL 1 50 T LICENSE NO
MOTORS OVER NOT OVER HP DISTRICT NO GROUP Z E PR CES D BY
O 1 100 r S Q 'y„
I s ISO INSPECTION RECORD
s 8 200 �// (7
8 15 250 � ' , c,- �-
15 50 300 p,
50 100 500 1"^�rf BOJ
SIGNS NO TRANS t / O
NO LAMPS t d�.
rr
SERVICE O 600V NOT OVER 200A 1 00
SERVICE O 600V OVER 200 A 1200614 A&Zjf Z
SERVICE OVER 600V 500
OTHER (SEE COMPLETE FEE SCHEDULE) - • `
PERMIT ISSUING FEE _ 200
SUPPLEMENTARY PERMIT ISSUING FEE 1100j
APPROVALS DATE INSPECTOR B BIGNATUR6
TOTAL FEE1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AUNDERSLAB WORK
AND STATE THAT THE ABOVE IS CORRECT AND AGREE ROUGH CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS RELECTRICAL WIRINGWIRING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERFIXTURESLICENSED AS REQUIRED BY LOS ANGELES COUNTY ANCALIFORNIA OR THAT I AM THE LEGAL OWNER F AND POWER
RESIDE IN THE ABOVE DESCRIBED RESIDE TI L ROPE
SIGNATURE UTILITY CO NOTIFIED
OF PERMITTEE ,
FINAL
VALIDATI JOSEPH C ROOHAN
CK MO CA8H SUPERVISING ELECTRICAL ENGINEER
X9079.; JUN 14 2 D 4.50- 7