HomeMy Public PortalAbout5738AGNES AVE_Electrical (4) .76Ay6*c"" "--O ' APPLICATION FOR ELECTRICAL PERMIT
%_. ''COUNT.Y OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING '
BUILDING AND SAFETY DIVISION ADDRESS ,
JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY C ��
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
OUTLETS NO. EACHI FEE
OWNER
$ $
RECEPT._ MAIL
ADDRESS f P C-°
LIGHT TOTAL FIRST 20 .20
OVER 20 CIT TEL. NO 1~
SWITCH_ .10 PLAN CHECK
LIGHTING FIRST 20 20 APPLICANT
TOTAL ADDRESS
FIXTURES OVER 20 10
APPLIANCES CITY TEL. NO.W�bN
PERMIT r
RANGE DRYER_WTR. HTR._ APPLICANT l/
STA. COOK DISP. F.A.U. ADDRESS
SPACE HTR. AIR COND._)�_ CITY C TEL. N0.
CLOTHES WASH. DISHWASH. p� LICENSE NO. -- CLASS. �--
FAN OTHER 1.00 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
if 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
0 — 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES CO TY AND STATE OF
CALIFORNIA OR THAKuw
R 0 AND INTEND TO
1 — 10 3.00 RESIDE IN, THE ESIDE TIAL PROPERTY.
SIGNATURE d
10 - 50 5.00 OF PERMITTEE z 17 0
50 - 100 10.00
DISTRICT NO. ICLASS GROUP 110N lf9tuSE Y ce
100 - 500 15.00 C
a
SIGN, GAS SIGN AND ONE CIRCUIT 3.00 NOTES: CL
a
TUBE, OR z
MARQUEE ADDITIONAL CIRCUITS 1.00
77
SERVI CENOTOVER 600 VOLTS OR 200 AMP 2.00
APPROVALS DATE INSPECTOR'S SIGNATURE
SERVI CE OVER 600 VOLTS OR 200 AMP 5.00
TEMP.POWER POLE
TEMP SERVICE,POLE, &APPURTENANCES 3.00
UNDERSLAB WORK
TEMP LIGHT OR RECEPT. SYSTEM 3.00
ROUGH CONDIUT
WIRING
FIXTURES
PERMIT FEE (SUB TOTAL)
POWER AUTHORIZED
PLAN CHECK FEE (50% PERMIT FEE)
UTILITY CO. NOTIFIED
PERMIT ISSUING FEE 2.00
FINAL
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
I E ROOHAN
TOTAL FEE SUPERVISING ELECTRICAL ENGINEER,
PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION M.O. CASH
r a u 6 9� FE324 2 D ���3�,00w
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE