HomeMy Public PortalAbout4949AGNES AVE_Electrical (8) 76A663C CE806B 12/76 APPLICATION FOR ELECTRICAL PERMIT
BUILDING SAFETY DIV ON
FOR APPLICANT TO FILL IN ,JOB 9850 KEY ME`,r�l J r
New Residential Bidgs &Pools
EACH NO FEE ADDRESS
1 &2 Finaily Sq Ft $ — $ LOCALITY
Multifamily Sq Ft — NEAREST
CROSS ST
Residential Swimming Pools OWNER OR
FIRM NAME WIIBF'RT , r'~—%L
Outlets Light Switch &Receptacle MAIL A��7,
ADDRESS StiL'1E
Additional CITY dd
A =M CITY Tel No 287-2793
Addo
PLAN CHECK
Lighting Fixtures APPLICANT
First 20 ADDRESS
Additional
CITY Tel No
PERTRAM
Fixed Appliances Not Over 1 HP APPLICANT HCC
Range Heater_ D W ADDRESS 2034 N PECK RD
Oven Dryer W M
Top FAU X W H CITY Tel No579-7982
Hood Fan 1 50LICENSE
Disp AC EG NUMBER 265094 Class C-10
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I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION Q
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY i--
Power Apparatus& Large AppliancesWITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING LU
Size&Type HP KW KVA or KVAR ELECTRICAL WIRING
Up to 1 Incl Z
5 1 HEREBY CERTIFY THAT I AM PROPERLY RECIISTERED AND/OR
Over 1 to 10 Inct LICENSED AS REQUIRED BY LOS ANG S COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE GA O ER� OF THE AB E
Over 10 to 50 Incl DESCRIBED RES IDENTI L RO RT
Over 50 to 100 Incl PERMITEE
Over 100 SIGNATURE
I
Services y DISTRICT NO
r OCE ED'BY
0 200 Amp Under 600 V 4 50
201 1000 Amp Under 600 V
Over 1000 Amp or Over 600 V APPROVALS `DATE INSP TOR S
SIGNATURE
`
A f_tr TEMP POWER POLE \
Temp Power Pole&Appurtenances UNDERSLAB WORK \�
Sign with One Branch Circuit
I
Additional Sign Branch Circuits
ROUGH CONDUIT
(Other) WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FEE (SubTotall 50 UTILITYCO NOTIFIED
PLAN CHECKING FEE (One Fourth Permit Fee) FINAL
PERMIT ISSUING FEE 4 50
NOTES -
TOTAL FEE 15 00 _ ~'
PLAN CHECK VALIDATION CK MO CASH PERMIT VALIDATION CK Mo CASH
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1 5,7AUG 11 2 1 5 0 0 At,,
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