HomeMy Public PortalAbout5004AGNES AVE_Electrical (6) 76A663-CE806 8-62 APPLICATION FOR ELECTRICAL ERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING rr _
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY L
NEAREST /
FOR APPLICANT TO FILL IN CROSS ST 6e y
RECEPT TOTAL NO EACH FEE
OUTLETS FIRST 20 IS 20 $ OWNER
LIGHT MAIL
ADD +0 ADDRESS '
SWITCH OVER 20
LIGHTING
TOTAL F1R5720 20 CITY TEL NO
v
FIXTURES I � ADD OVFR 20 10 ELECTRICIAN d
RANGES CLO DRYERS WTR HTRS 1 OO ADDRESS / OI
GARB DISP STA COOK '.
CITY TEL NO
DISH WASH AUTO WASH STATE
SPACE HTRS STA APP ('/,H P MAX 1 50 LICENSE NO ¢
MOTORS OVER NOT OVER H P DISTRI�CGO T G P Z NE PF�Q SSED BY
O 1 100 / V l (J
+ 3 150 ) I INSPECTION RECORD
3 8 200 �A9 G /4 � c� 1I-7, L l ftp/�l Y r
8 +5 250
15 50 300 d
50 100 500 ,y/•^ f! u
SIGNS NO TRANS '' - l r cz
NO LAMPS
O
H
SERVICE O 600V NOT OVER 200A 1100 -� Lu
CL
SERVICE O 600V OVER 200 A 200 NV)
SERVICE OVER 600V 500 ?
MISC
PERMIT ISSUING FEE 200
SUPPLEMENTAgY PERMIT ISSUING FEE 100
TOTAL FEE $ ��
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING WIRING �q
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF [FINAL
XTURES
CALIFORNIA OR THAUAH LEGAL OWNER OF THE ABOVE I
DESCRIBED RESIDENTTHAOWER
SIGNATURE TILITY CO NOTIFIED
OF PERMITTEE
IDATI
AC LVETT
U/ CASCK MO
H SUPERVISING ELECTRICAL ENGINEER
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