HomeMy Public PortalAbout5218AGNES AVE_Electrical (2) 76g66 CE806 10/72JV APPLICATIO lkTR�L 'PERMIT
COUNTY OF LOS ANGELES
' DEPARTMENT OF COUNTY ENGINEER JOB
ADDRESS
BUILDING AND SAFETY DIVISION
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST 1
DI.I,TLETS NO EACH FEE OWNER OR
/
5 $ FIRM NAME
RECEPT MAIL 1
FIRST 20\ 25 ADDRESS
LIGHT_ TOTAL
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CITY TEL NO
SWITCH C.9- OVER 20 10
PLAN CHECK
FIRST 20 �J APPLICANT—
LIGHTING 25 �
TOTA �
FIXTURES
OVER 20 10 ADDRESS I
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RESIDENTIAL APPLIANCES CITY TEL NO
PERMIT T
RANGE DRYERoll
WTR HTR_ APPLICAN /
STA COOK DISP F A U ADDRESS
SPACE HTR AIR COND I CI TEL N�
CLOTHES WASH DISHWASH S LICENSE OR
REG NUMBER CLASS
FAN OTHER 100 1 HENEBI 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
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
0 — 1 100 LICENSEDAS REOU Y LOS ANGELES COUNTY AND STATE OF
CALIF IA AT THE LEGAL OWNER OF THE ABOVE
�J OES�'RI ES NTIAL PROPERTY
1 — 1 0 3 00 V 0
PE [TEE% C..7
y, 10 — 50 1500 SI NATURE LL'
O
50 — 100 1000
DISTRICT NO I PROC PSED BY W
100 — 500 1500 Z
SIGN GAS SIGN AND ONE CIRCUIT 500 APPROVALS DATE INSPECT SSIGNATURE
TUBE OR
MARQUEE ADDIITIONAL CIRCUITS 100 TEMP POWER POLE
SERVICENOTOVER600VOLTS OR200AMP 300 UNDERSLAB WORK
SERVI CE OVER 600 VOLTS OR 200 AMP 1000 , ROUGH CONDUIT
TEMPSERVICE POLE &APPURTENANCES 500 WIRING Al
r
TEMP LIGHT OR RECEPT SYSTEM 300 FIXTURES / a �' �
POWER AUTHORIZED
c UTILITY CO NOTIFIED
FINAL
PERMIT FEE (SUB TOTAL) NOTESJ'�/ -71/ 61OWI) 0,__f/0
PLAN CHECK FEE Q fL S�F_r_'A
PERMIT ISSUING FEE i 300 ,
TOTAL FEE .7-3
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION cK M o CASH
6 1 1 1 NOV 4 2 7.2 5 AW
I/
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
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