HomeMy Public PortalAbout5128AGNES AVE_Electrical (4) 78A663 CE808 10,74 APPLICATION FOR ECIRICA, PERM T
`COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER FADDRESS
BUILDING AND SAFETY DIVISION
TY
ST
FOR APPLICANT TO FILL IN 7 ST
OUTLETS NO EACH 1 FEE OWNER OR
$ $ FIRM NAME
RECEPT_ MAIL
LIGHT TOTAL
FIRST 20 25 ADDRESS
CITY TEL NO �f
SWITCH OVER 20 10 I `
PLAN CHECK
LIGHTING TOTAL FIRST 20 25 APPLICANT
FIXTURES
OVER 20 t0 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL NO
PERMIT
RANGE DRYER_WTR HTR_ APPLICANT S
STA COOK DISP F A U ADDRESS 1
SPACE HTR AIR COND CITY co TEL NO l 3\
CLOTHES WASH DISHWASH LICENSE OR CLASS
REG NUMBER
FAN OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND HEATERS ETC HP KW KVA ELECTRICAL WIRING
SIZE & TYPE OVER TO
IHEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAI I AM THE LEGAL\OWNER OF THE ABOVE �
DESCRIFED RESIDEI ROPERTY O
1 - 10 , 1 1 1II 300��+ l `1J'", I II , 'It , GO
PERMITEEII 11
10 - 50 500 (I SIGNATURE CD
F--
50 - 100 1000 v
DISTRICT NO PROC SED B W
a.
100 - 500 1,,00 /y Z
SIGN GAS SIGN AND ONE CIRCUIT 500 (/
APPROVALS LS DATE INSPEC RSSIONATURE
TUBE OR
MARQUEE ADDITIONAL CIRCUITS 100 TEMP POWER POLE
SERVICE NOTOVER 600 VOLTS OR 200 AMP 300 UNDERSLAB WORK
SERVI CE OVER 600 VOLTS OR 200 AMP 1000 ROUGH CONDUIT
TEMPSERVICE POLE &APPURTENANCES 500 WIRING
TEMP LIGHT OR RECEPT SYSTEM 300 FIXTURES
POWER AUTHORIZED
UTILITY CO NOTIFIED
IFINALPERMIT FEE (SUB TOTAL)
PLAN CHECK FEE r
PERMIT ISSUING FEE 300
TOTAL FEE
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION cK M 0 CASH
2 4 3 r tUL26 2 9 9.0 0
v
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE Y�/