HomeMy Public PortalAbout4906AGNES AVE_Electrical (2) 76A,63 CE1 610,74 APPLICATION FOR LECTRItAL PERMIT
I COUNTY OF LOS ANGELES /
4eAPARTMENT OF COUNTY ENGINEER
AND SAFETY DIVISION ADDRESS D 6 �,r
BUILDING
LOCALITYNEAREST v
('jT
FOR APPLICANT TO FILL IN CROSS ST .S/Cf' �A R25.54
OUT ETS NO EACH FEE OWNER OR FIRM NAME L041i j fra4,NCO
j / -r
LIGHT TOTAL FIRST 20 ADDRESS 0/,9 b ")/ A f '
OVER 20 CITY :r TEL NO .11 62611
SWITCH PLAN CHECK
LIGHTING l FIRST 20 t4 APPLICANT
)} TOTAL
FIXTURES%
OVER 20 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL NO
PERMIT
RANGE DRYER_WTR HTR APPLICANT
STA COOK DISP F A U ADDRESS 1
SPACE HTR AIR COND CITY TEL NO
CLOTHES WASH DISHWASH LICENSE OR
r7�0 I REG NUMBER CLASS
FAN OTHER -LA0 IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND HEATERS ETC HP KW KVA ELECTRICAL WIRING %
512E & TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
A �..
CALIFORNIA OR THAI I AM THE LEGOWNER OF THE ABOVE
1 - 10 300 DESCRIPED RESIDENT AL PROPERTY V
PERMITEE n=
10 - 50 500 SIGNATURE CD
V
50 - 100 1000 LLS
DISTRICT NO ROCES ED BY h
100 - 500 100 . d 8 , ?
SIGN GASSIGN AND ONE CIRCUIT 500 APPROVALS DATE INSPECTOR S SIGNATURE
TUBE OR
MARQUEE ADDITIONAL CIRCUITS 100 TEMP POWER POLE
SERVI CENOTOVER 600 VOLTS OR 200 AMP 300 UNDERSLAB WORK
SERVICEOVER600 VOLTS OR 200AMP 1000 ROUGH CONDUIT
TEMP SERVICE POLE &APPURTENANCES 500 WIRING '� 6
TEMP LIGHT OR RECEPT SYSTEM 300 FIXTURES
s
POWER AUTHORIZED
UTILITY CO NOTIFIED
FINAL �r/ ►� '/ t.�
PERMIT FEE (SUB TOTAL) NOTES L/
PLAN CHECK FEE
PERMIT ISSUING FEE 300
TOTAL FEE
PLAN CHECK VALIDATION CK M o CASH PERMIT VALIDATION cK M o CASH
4 1 5E.Inrr r_2 2 0 730 a_�.
1
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE ~'�'