HomeMy Public PortalAbout4840AGNES AVE_Electrical (2) APPLICATION FOR ELECTRICAL PER
RREPARO
UNTYOF LO+S ANGELES
TMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS Q �'
JOHN A LAMBIE COUNTY ENGINEER /
COLEMAN W JENKINS SUPERINTENDENT OF BUILDING LOCALITY PLP [
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
NO EACH FEE
RECEPT
$ $ OWNER �
MAIL S
LIGHT ` TO AL FIRST 20 20 0 ADDRESS 1
SWITCH OVER 20 10 CITY P TEL NO
LIGHTING �TOTAL FIRST 20 20 D CONTRACTOR '''} 1100
FIXTURES OVER 20 10 ADDRESSpoo Wt Al ([
RANGE—DRYER—WTR HTR — CITY j4 TEL NO(r/Q&/L
STA COOK_DISP _F A U _ LICENSE NO `7
SPACE HTR AIR COND I HEREBY ACKNOWLEDGE THAT r HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
CLOTHES WASH -DISHWASH WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING
FAN-OTHER 1 00 I"HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
MOTORS TRANSFORMERS RATING CALIFORNIA OR THAT I AM THELE OWNER OF AND INTEND TO
IND HEATERS ETC HP KW KVA RESIDE IN THE A OVE DESCR BE RESIDENTIAL PROPERTY
SIZE & TYPE OVER TO I SIGNATURE
0 - 1 1 0070
OF PERMITTEE
1 - 10 3 00 DISTRICT O OUP Z NE PR D V
10 - 50 5 00 1-5710
50 - 100 10 00 NOTES ( L�
VW
100 - Soo 15 00 N
SIGN GAS SIGN AND ONE CIRCUIT 3 00
TUBE OR
MARQUEE ADDITIONAL CIRCUITS 1 00
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00
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
ISSUING FEE 2 00 �!�
FIXTURES �
SUPPLEMENTARY ISSUING FEE 1 00
POWER AUTHORIZED
PERMIT FEE UTILITY CO NOTIFIED
PLAN CHECK FEE (50% PERMIT FEE) FINAL
TOTAL FEE JOSEPH C ROOHAN
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION o
LM 0 CASH
i'1+ O6 -, 3 u.� SEP 2 D 4 40N
EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE Of