HomeMy Public PortalAbout5136AGNES AVE_Electrical (4) 76A663 CE806 12 65 APPLICATION FOR ELECTRI L PERMIi7 'fl
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING /
BUILDING AND SAFETY DIVISION ADDRESS (� IL S
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUPERINTENDENT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST L 4 14 Al/U
RECEPT k TOTAL No EACH FEE
OUTLETS I FIRST 20 / $ 20 $ O OWNER Ar T
LIGHT
j
MAIL //__
/ ADD L 10 ADDRESS &A
SWITCH
/---� OVER 20 _ ,( �7
TOTAL FIRST 20 20 CITY L' f'EL �� /
LIGHTING 1 FIXTURES NO/ _
FIXTURES )r ADD L 1O CONTRACTOR < LL'
OVER 20 /
RANGES DRYERS WTR HTRS 100 ADDRESS 0/1 At A4
GARB DISP STA COOK
4 CITY L eL NO
DISH WASH AUTO WASH STATE /,s
SPACE HTRS STA APPL 50 LICENSE NO / ,J
MOTORS OVER NOT OVER HP DIS15ICT NO, annup ZONE P O D
0 1 100
1 s 150 INSPECTION RECORD 0
s a 200 V
s is 250 ~O
15 50 300 V
W
50 100 5 00
N
Z
SIGNS NO TRANS
NO LAMPS
SERVICE O 600V NOT OVER 200A 100
SERVICE O 600V OVER 200 A 200
SERVICE OVER 600V Soo
OTHER (SEE COMPLETE FEE SCHEDULE)
PERMIT ISSUING FEE 2 00
SUPPLEMENTARY PERMIT ISSUING FEE 100 APPROVALS DATE INSPECTOR B SIGNATURE
TOTAL FEE 3 O
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION UNDERSLAB WORK /►�
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ROUGH CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING d
ELECTRICAL WIRING WIRING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF K RAND d•7FEND TO POWER
RESIDE IN THE ABOV DESCRIBED RESIDENTIA OP TY
1,14
SIGNATURE i UTILITY CO NOTIFIED
OF PERMITTEE
FINAL
VAIIDAT JOSEPH C ROELEC
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
6s0 '3zg M30 2 D 3.20- q