HomeMy Public PortalAbout5728AGNES AVE_Electrical (2) 76A 663-CE806 3-69 u //� r
APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY h y�y J B
FOR APPLICANT TO FILL IN NEAREST
NO. EACH FEE
$ $ OWNER
RECEIPT. MAIL p
LIGHT � TOTAL
FIRST 20 4 ,20 ADDRESS A
�C CITY TEL. 0. . o
SWITCH `S OVER 20 .10 PLAN CHECK
LIGHTING TOTAL FIRST 20 ,20APPLICANT
FIXTURES Le—i OVER 20 .101 1 ADDRESS
RANGE_DRYER_WTR. HTR. CITY TEL.NO.
STA. COOK__DISP. F.A.U. CONTRACTOR
SPACE HTR. AIR COND. ADDRESS -
CLOTHES WASH. DISHWASH. CITY T .NO.
FAN OTHER 1.00 LICENSE NO. CLASS.
MOTORS,TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
IND. HEATERS, ETC. HP. KW. KVA. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
0 - 1 1.00 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATEOF }
1 - 10 3.00 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO O.
RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. c
10 — 50 5.00 1 L
SIGNATURE / r''/ ✓ GC
50 — 100 10.00 OF PERMITTEE Y Q
F-
100 - 500 15.00 DISTRICT NO. I I JG ROUP ZON P ESS D BY U
W
SIGN,GAS SIGN AND ONE CIRCUIT 3.00 - Q� Z
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES:
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00
SERVICE OVER 600 VOLTS OR 200 AMP 5.00
TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP. POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT y , g
WIRING f Y � GPd¢
PERMIT FEE (SUB TOTAL) FIXTURES
PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED
17
PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL
TOTAL FEEr JOSEPH C. ROOHAN
SUPERVISING ELECTRICAL ENGIN R
PI. cK.
PLAN- CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION M.O. l:ASH
'�.s 4 2 0:9 JAN 21 2 D 1 0.40~ g
SEE BACK OF APPLICATION FOR COMPI.FTF FEE SCHEDULF