HomeMy Public PortalAbout4901AGNES AVE_Electrical (6) D DEP12 43 25M
APPLICATION FOR PERIIIIT
RTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES ELECTRIC
WM J FOX. CHIEF ENGINEER
Z DISTRICT NO GROUP ZONE �JPEsjRMIT NO
NAME �r -- A-1 /�C Q �f
U ADDRESS � � L
W CITY ftl- NO
RECEIVED BY FI TINREADY FOR ECTION DATE ISSUED
CERT NO EXPIRES 4 `� �-3l
COUNTY //
APPLICANT FILL IN HEAVILY OUTLINED PORTIO ONLY
DESCRIPTION OF WORD ADDRESS /
NUMBER OF OUTLETS ON CIRCUITS LOCALITY
LOCATION BY ROOMS NEAREST
LIGHT OUTLETS SW PLUGS FIXT CROS93 ST A-4.4—
CIRCUIT A B C D I E F G JH E NAME
Z MAIL
If
/1
3 ADDRESS i C
O
CITY TEL NO
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF QUALIFICATION
ELECTRICIAN
1 AM THE LKW&OI F THE PROPERTY DESCRIBED
ABOVEr��
OWNER
CORRECTIONS
J
— a
z
n
0
TOTAL
NO OF OUTLETS 02-4 $ APPR6VALS
NO OF FIXTURES ly $ //o DATE INSPECTOR S NAME
L
F MOTORS HP $ CONDUIT
F SIGNS TRANS ffi WIRING
F RANGES OR HEATERS $ FIXTURES
LLANEOUS $ POWER
T FEE $ UTILITYCO NOTIFIED FEE FINAL 6 a Ql