HomeMy Public PortalAbout5219AGNES AVE_Electrical (2) 76A663 CE806 10/72 APPLICATFO ELIECTRICAL PE � 3T
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COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER OB 1� 1
BUILDING AND SAFETY DIVISION ADDRESS J ✓�—
LOCALITY _
NEAREST 1 D r
FOR APPLICANT TO FILL IN CROSS ST /'/
OUTLETS NO EACH FEE OWNER OR ��
S S FIRM NAME Cl
RECEPT ADDRESS �� _I
MAIL
LIGHT TOTAL FIRST 20 26 � CITY �` � TEL NO
_ OVER 20
SWITCH 10 PLAN CHECK
FIRST 20 25 APPLICANT
LIGHTING TOTAL
OVER 20 ADDRESS
FIXTURES 10
RESIDENTIAL APPLIANCES CITY TEL NO
RANGE DRYEPWTR HTR APPLIPERMI ul
ANT j
t 1nN O Z
STA COOK DISP F A U ADDRESS I y V-
SPACE HTR AIR COND CITY Q,;'IT
TEL NO ► �1y3
CLOTHES WASH DISHWASH LICENSE OR O^n�
REG NUMBER "` CLASS
FAN OTHER 100 1 HEHEBN 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 y
SIZE & TYPE OVER TO
I HEREBY CERTIFY THAT M PROPERLY REGISTERED AND/OR
0 - 1 100 LICENSED AS REQUIRE BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAI I AM THAF LEGAL OWNER OF THE ABOVE }
1 - 10 300 r DESrRICE RE �DENTI PRO RTY
O
PERM ITE t)
10 - 50 500 SIGNAT RE
50 - 100 1000
DISTRICT NO PROC SED BYE W
100 - 500 100 /j O N
v✓ Z
SIGN GAS SIGN AND ONE CIRCUIT 500 APPROVALS DATE INSPECTO SIGNATURE
TUBE OR
MARQUEE ADDITIONAL CIRCUITS 100 TEMP POWER POLE
SERVICENOTOVER600VOLTS OR200AMP 300 00 UNDERSLAB WORK
SERVICEOVER 600 VOLTS OR 200AMP 1000 ROUGH CONDUIT
TEMPSERVICE POLE &APPURTENANCES 500 WIRING
TEMP LIGHT OR RECEPT SYSTEM 300 FIXTURES
POWER AUTHORIZED 001
UTILITY CO NOTIFIED
FINAL 1 719 If Uff
PERMIT FEE (SUB TOTAL) NOTES
PLAN CHECK FEE
PERMIT ISSUING FEE 300
do
TOTAL FEE
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VA ATION M o CA
1
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
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