HomeMy Public PortalAbout5803AGNES AVE_Electrical (4) 78A88,/L CE808B 12/74
APPLICATION FOR ELECTRICAL PERMIT
'�':naILDING SAFETY DTVI N ,I y/�/ �^
FOR APPLICANT TO FILL IN JOB
ADDR ��� 1 �ES //�`
FRedenntial Bldgs & Pools EACH NO FEE
aily Sq Ft $ — $ LOCALITY
Multifamily Sq Ft — NEAREST
CROSS A
al Swimming Pools ST
OWNER OR
FIRM NAME
ht Switch& Receptacle MAIL
Q ADDRESS
l CITY Tel No a�s�IG 941
PLAN CHECK
Lighting Fixtures APPLICANT
First 20 ADDRESS
Additional �+ /c 1
CITY 2J� Tel No EI�iC � L Co
PERMIT
Fixed Appliances Not Over 1`HP APPLICANT
Range Heater ---DW ADDRESS Z�S� O—A(1 go eLhA
Oven Dryer W M �y G /J
Top FAU WH / CITY SOA Y,+ Tel No -1 UP a
Hood Fan ! LICENSE OR p+�j �7 a
REG NUMBER a • / Class p
Dlsp A C v
it
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY O
Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
Size&Type HP KW KVA or KVAR ELECTRICAL WIRING U
LLI
Up to 1 Incl I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/Oft
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 RESIDENTIAL PROPS Y
Over 50 to 100 Incl PERMITEE
Over 100 SIGNATURE
4A!2�
IDISTRICT NO r--� P ES ED BY
Services / O /)
0 200 Amp Under 600 V j�
201 1000 Amp Under 600 V APPROVALS DATE INSPE OR S
SIG AT
Over 1000 Amp or Over 600 V
EMP POWER POLE
Temp Power Pole&Appurtenances NDERSLAB WORK
Sign with One Branch Circuit
Additional Sign Branch Circuits OUGH CONDUIT
(Other) IRINGIXTURES
OWER AUTHORIZED
PERMIT FEE (Sub Total) UTILITYCO NOTIFIED
PLAN CHECKING FEE (One Fourth Permit Fee) FINAL ' Z-
ZZ
PERMIT ISSUING FEE ITOTALFEE NOTES
S
PLAN CHECK VALIDATION CK MO CASH PERMIT VALIDATION K MO CASH
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