HomeMy Public PortalAbout4958AGNES AVE_Electrical 7
76A663_4CE80¢ 4.s8 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS L[ fli
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUPERINTENDENT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
NO EACH FEE
RECEPT�
$ $ OWNER
MAIL �
LIGHT 7-j TOTAL FIRST 20 20 q d6 ADDRES
SWITCH OVER 20 10 CITY TEL NO y - 1 6
PLAN CHECK
LIGHTING TOTAL FIRST 20 Z 20 2 4DAPPLICANT
FIXTURES =12OVER 20 10 ADDRESS
RANGE—DRYER—WTR HTR — CITY TEL NO
STA COOK_DISP ��F A U COINTRAC rOR
SPACE HTR AIR COND ADDRESS7to , tsl ,3
CLOTHES WASH V.111DISHWASH ']n(
CITY TEL NO
FAN—OTHER 1 00 oa LICENSE IJO --7 1 Z CLASS m
MOTORS TRANSFORMERS RATING
IND HEATERS ETC HP KW KVA I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE & TYPE OVER TO AND STATE THAT TME ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
0 - 1 1 00 ELECTRICAL WIRING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
1 - 10 3 00 LICENSED AS REQUIRED Y LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I A THE LEGAL WNER OF AND INTEND TO
10 - 50 5 00 RESIDE IN THE AB DES GRIPE RESIDENTIAL PROPERTY
50 - 100 10 00 SIGNATURE O
OF PERMITTEE U
too - 500 1500 DISTRICT NO GR UP NEP/-9CESSED BY o
SIGN GAS SIGN AND ONE CIRCUIT 3 00 �/ �� / ~
TUBE OR U
LL,
MARQUEE ADDITIONAL CIRCUITS 1 00 NOTES �
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00
SERVICE OVER 600 VOLTS OR 200 AMP 5 00
TEMP SERVICE POLE &APPURTENANCES 3 00 APPROVALS DATE INSPECTOR S SIGNATURE
TEMP POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
PERMIT FEE (SUB TOTAL) WIRING
FIXTURES
PLAN CHECK FEE (5017 PERMIT FEE)
POWER AUTHORIZED
PERMIT ISSUING FEE 2 00 UTILITY CO NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL
.47 1477 C4
TOTAL FEE JOSEPH C ROO AN
SUPERVISING EL AL ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M O CASH
)NEE9 4 r~ 62�3 Wit D 1 7 -1 C)-
EE
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