HomeMy Public PortalAbout5218AGNES AVE_Electrical (7) 78A887C`C68088 12/74
APPLIC=BUILDING
ECTRICAL PERMIT
TY DIV N
FOR APPLICANT TO FILL IN ,JCB
New Residential Bldgs &Pools
EACH NO FEE ADDR SS S
1 &2 Finaily Sq Ft $ — $ LOCALITY
Multi family Sq Ft — NEAREST
CROSS ST
Residential Swimming Pools OWNER OR
FIRM NAME (f
Outlets Light Switch &Receptacle MAIL
First 20 ADDRESS
Additional CITY Tel No
PLAN CHECK
Lighting Fixtures / APPLICANT
First 20 ! ADDRESS
Additional
CITY Tel No
PERMIT
Fixed Appliances Not Over 1 HP APPLICANT
Range Heater—L— W
ADDRESS
Oven Dryer W M
Top FAU W H CITY K1� Tel No
G I >-
Hood Fan REG EOR 3 / Class G� O
REG NUMBER 3
Disp A C
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY Q
Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
Size&T ELECTRICAL WIRING V
Type HP KW KVA or KVAR w
a_
Up to 1 Incl I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
Over 1 to 10 Incl LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
Over 10 to 50 Incl DESCRIBED RE51D NTIAL PROPERTY
Over 50 to 100 Incl PERMITEE 4A&/V
Over 100 SIGNATURE,
Services DISTRICT NO 0 cys S�DB
0 200 Amp Under 600 V ID
201 1000 Amp Under 600 V APPROVALS DATE INS CTURRE
S
NATU
Over 1000 Amp or Over 600 V
TEMP POWER POLE
Temp Power Pole&Appurtenances UNDERSLAB WORK
Sign with One Branch Circuit
Additional Sign Branch Circuits ROUGH CONDUIT
(Other) WIRING
FIXTURES
I
POWER AUTHORIZED
PERMIT FEE (Sub Total) IF
ILITYCO NOTIFIED
PLAN CHECKING FEE (One Fourth Permit Fee) NALPERMIT ISSUING FEE
TOTAL FEETES
r , 1
PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATIO CK M O CASH
1 2 0NNIFR 2i 2D 1 650 ®