HomeMy Public PortalAbout5021AGNES AVE_Electrical (5) 76A663C CES06B 12/75 APPLICATION FOR ELECTRICAL PER IT
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BUILDI AND SAFE DIVISION
FOR APPLICANT TO FILL IN J 7�B 021 Ly ACMES AVE
rRedenyalial Bldgs &Pools EACH NO FEE ADDRESS
y Sq Ft $ — $ LOCALITY MIPLE
Multifamily Sq Ft — NEAREST
CROSS ST
Swimming Pools OWNER OR
FIRM NAME ,
AKIhUK
Switch& Receptacle MAI L5�,�,irst ADDRESS
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Additional CITYCITY Tel No 285-
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PLAN CHECK
Lighting Fixtures APPLICANT
First 20 ADDRESS
Additional
CITY Tel No
PERMIT 'fKAM HCC
Fixed Appliances Not Over 1 HP APPLICANT
Range_ Heater_ D W ADDRESS 2034 N PECK M
Oven Dryer W M
Top FAU W H CITY S EL MDNM Tel NO 579-7982
Hood Fan LICESE OR
REG NNUMBER 265094 Class C-10 v
Disp AC
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION O
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY F—
Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING V
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Size&Type HP KW KVA or KVAR ELECTRICAL WIRING p
Up to 1 InclZ
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
Over 1 to 10 Incl LICENSED AS REQUIRED By LOS ANGEL COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LE L OWN OF THC ABOVE
Over 10 to 50 Incl DESCRIBED RES DENT qL P@OP T
Over 50 to 100 Incl PERMITEE
Over 100 SIGNATURE
DISTRICT NO P OCE ED BY
Services 08 l �j
0 200 Amp Under 600 V 4 50 L/C,7
201 1000 Amp Under 600 V APPROVALS DATE ISI CTOR S
Over 1000 Amp or Over 600 V
Sl NATURE
TEMP POWER POLE
Temp Power Pole&Appurtenances UNDERSLAB WORK
Sign with One Branch Circuit
Additional Sign Branch Circuits ROUGH CONDUIT
(Other) WIRING
FIXTURES
POWER AUTHORIZED
eV.
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(Sub Total) UTILITYCO NOTIFIED
PLAN CHECKING FEE (One Fourth Permit Fee) FINAL
PERMIT ISSUING FEE
TOTAL FEE NOTES
1 In
PLTAN`CWECI1>YSLI1V�T40�P ce�.� Ck+ NCASH� PERMIT VALIDATION CK MO CASH
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