HomeMy Public PortalAbout5234AGNES AVE_Electrical (5) OD
7eA653 CEB06 1/70 APPLICATION FOR ELECTRICAL PERMI
COUNTY OF LQS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION a'DRES
JOHN A LAMBIE COUNTY ENGINEER LOCALITY
COLEMAN W JENKINS SUPERINTENDENT OF BUILDING 4 . - -_ 11-el
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
OUTLETS NO EACH I FEE
s Is OWNER
RECEPT MAIL
FIRST 20 20 /_T ADDRESS
LIGHT T AL' C�7V
OVER 20 CITY TEL NO
SWITCH 10 PLAN CHECK
FIRST 20 20 APPLICANT
LIGHTING
Zt�DVERFIXTURES 10 20 ADDRESS
APPLIANCES CITY TEL NO
PERMIT
RANGE DRYER_WTR HTR APPLICANT
STA COOK DISP F A U ADDRESS zga
SPACE HTR AIR COND CITY TEL NO
CLOTHES WASH DISHWASH LICENSE NO � '� CLASS
FAN OTHER 100
I 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
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
O - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
1 - 10 300 RESIDE IN THE ABOVE DESCRIPED RESIDENTIAL PROPERTY
10 - 50 500 SIGNATURE
a
OF PERMITTEE O
50 - 100 1000
DISTRICT NO CLASS GROUP ZONE PR E ?7Y DC
100 - 500 1500 ^ I
SIGN GAS SIGN AND ONE CIRCUIT 300 NOTES UJ
Cr_
TUBE OR Z
MARQUEE ADDITIONAL CIRCUITS 100 /`L /
SERVI CENOT OVER 600 VOLTS OR 200 AMP 200
APPROVALS DATE IN rR S SI RE
SERVICEOVER600VOLTS OR200AMP 500
TEMP POWER POLE
TEMPSERVICE POLE &APPURTENANCES 300
UNDERSLAB WORK
TEMP LIGHT OR RECEPT SYSTEM 300
ROUGH CONDIUT
WIRING
FIXTURES
PERMIT FEE (SUB TOTAL)
POWER AUTHORIZED
PLAN CHECK FEE (507 PERMIT FEE)
UTILITY CO NOTIFIED
PERMIT ISSUING FEE 200 40
FINAL
SUPPLEMENTARY PERMIT ISSUING FEE 100
JOS PH C RO )HAN
TOTAL FEE SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK� M 0 CASH
80-SE9 8 4 1c-- HRR22 2 D 580-
SEE
E BACK OF APPLICATION FOR COMPLETE SCHEDULE