HomeMy Public PortalAbout4942AGNES AVE_Electrical (3) 76A663 CE806 j 68 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE COUNTY ENGINEER vu
COLEMAN W JENKINS SUPERINTENDENT OF BUILDING LOCALITY
NEAREST
FHTR
OR APPLICANT TO FILL IN CROSS ST L
/ NO EACH FEEy p y2 $ $ OWNER �L C�(�TOTAL FIRST 20 20 AAl L
DDRESSr /)/ OVER 20 10 CITY e-!�1 L ` C NO A-' �I
PLAN CHECK
G TOTAL FIRST 20 20 APPLICANT
S OVER 20 10 ADDRESS
DRYER—WTR HTR CITY TEL 0
K_DISP F A U COIJTRACFORTR AIR CONDADDRESSS WASH _DISHWASH CITY TEL NO
OTHER 1 1 00 1 90 LICENSE IJO CLASS
MOTORS TRANSFORMERS RATING
IND HEATERS ETC HP KW KVA I HEREBI ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING
0 - 1 1 00
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
1 - 10 3 00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF }
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO D.
10 - 50 5 00 RESIDE IN THE ABOVE DES RIPED RESIDE TIAL PROPERTY O
SIGNATURE V
50 - 100 10 00 OF PERMITTEE
100 - 500 15 00
DISTRICT NO GROUP PR ESSE BYVo
G
TUBE OR SSIGN GAS IGN AND ONE CIRCUIT 3 00 r a
MARQUEE ADDITIONAL CIRCUITS 1 00 aa NOTES Z
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00
SERVICE OVER 600 VOLTS OR 200 AMP 5 00 s f
TEMP SERVICE POLE &APPURTENANCES 3 00 APPROVALS DATE INSPECT SSIGNATURE
TEMP POWER POLE
UNDERSLAB WORK
L/`' ROUGH CONDU T
WIRING 1>r r ..• S
PERMIT FEE (SUB TOTAL)
PLAN CHECK FEE (507 PERMIT FEE) FIXTURES
POWER AUTHORIZED
PERMIT ISSUING FEE 2 00 UTILITY CO NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEEI 1 00 FINAL
TOTAL FEE JOSEPH C ROOHAN
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK m0
AS
— �5 2 0 2` X25 D 8.60
a
iEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE