HomeMy Public PortalAbout4913AGNES AVE_Electrical (4) DBS SA 25M BETS 2 47 Ag54f4FC TION FOR PE�>DAI! T
�..,,-'F O�CAiillt'lENT OF BUILDING AND
S i�SL1l.�tLlA 1N �'VH1 S�iLl��.i
` iiY+CtfLi COUNTY OF IJYg OadS1SL ANGELES -JEOI ECT IC
WM J FOX CHIEF ENGINEER
NAME -fir G DISTRICT NO GROUP ZONE PERMIT NO
U ADDRESS / 3 O R L !M� 4vo, 1 / 329a``9�O
�
U CITY A/0 40 v/lf 1-912-
�TEL NO / �� Rn
V By
READY FOR DATE ISSUED
W FIRST INSPECTIONTY
COUN
CERT NO 47900 EXPIRES
APPLICANT FILL IN HEAVIL QYTLINED POIt7.'ION ONLY
JOB
IDESCEIMON OF WOlM ADDRESS 50ofyes
NUMBER OF OUTLETS ON CIRCUITS LOCALITY /G/W0044- C17
LOCATION BY ROOMS
NEAREST &WA
LIGHT OUTLETS SW PLUGS IfrixT CROSS ST
CIRCUIT A B C D 1 E F IG H E NAME
MAIL
Ii � S / 3 ADDREESSS�'
a�v em � 2 , O CITY (C �!J y TEL NO
m-e,h4W 1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS
[>, / f , ANGELES COUNTY CERTIFICATE OF QUALJFICATION
ELECTRICIAN
�J I AM THE r Q�OWNER OF THE PROPERTY DESCRIBED
`L ABOVE
i3.frA OWNER
190 Am L / 3 COIWECTIONS
130Me-/ z / H5'7i'C Ail 7G 5 ONP AI s 7 c
4cle �mI l10OWS To AVA' d s r L
J
Q
Z_
L7
lr
O
TOTAL
NO OF OUTLETS �/ ffi APPROVALS
NO OF FIXTURESr D DATE INSPECTOR S NAME
NO OF MOTORS HP $ CONDLIT � IJ
-
$ IP rq.�4r,s
NO OF SIGNS TRANS f ffi WIRING 1 4
NO OF RANGES OR4gEATUalS / - !F+ FIXTURES
MISCELLAN90UN POWER
PERMIT FEE $ , UTILITYCO NOTIFIEQ - Ygol
TOTAL FEE FINAL