HomeMy Public PortalAbout5817AGNES AVE_Electrical (2) �,6013 CE806 468 APPLICATION FOR ELECTRICAL /PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS 5817 AGNES AVE
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUPERINTENDENT OF BUILDING LOCALITY TEMPLE CITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
NO $AC $ FEE OWNER MA AND MRS AMO
RECEPT _ -2 1MAIL 5$17 AGNES AVENUE
LIGHT TOTAL FIRST 20 " 20 O ADDRESS
SWITCH_ 2 OVER 20 10 CITY TEMPLE C TYTEL NO 187 771
0 PLAN CHECK
LIGHTING TOTAL FIRST 20 / 20 APPLICANT
FIXTURES –1— OVER 20 10 ADDRESS
RANGE_DRYER—WTR HTR — CITY TEL NO
STA COOK_DISP _F A U — COI,TRAC rOR COBINE ELECTRIC CO
SPACE HTR AIR COND ADDRESS 1607 (macmuT RT p
CLOTHES WASH _DISHWASH CITY ALHAMBRA TEL NO 282
FAN—OTHER 1 00 LICENSE NO 229847 CLASSC 10
MOTORS TRANSFORMERS RATING
IND HEATERS ETC HP KW KVA IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
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
I HEREBY CERTIFY THAT PROPERLY REGISTERED AND/OR
1 - 10 3 00 LICENSED AS REQUIRED LOS NGELES COUNTY AND STATE OF
CALIFORNIA OR THAT M THE EGA ER OF ND INTEND TO >-
10 - SO 5 00 RESIDE IN THE OVE C ED RESID AL PROPERTY Cl-
U
SIGNATURE
50 - 100 91
10 00 OF PERMITTE
100 - 500 15 00 ~
DISTRICT NO GR P ZOLN E P SE w
SIGN GAS
TUBE OR SIGN AND ONE CIRCUIT 3 00 i N
MARQUEE ADDITIONAL CIRCUITS 1 00
NOTES Z
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 SSIGNATURE
TEMP POWER POLE
UNDERSLAB WORK `
ROUGH CONDUIT
WIRING 1
PERMIT FEE (SUB TOTAL) FIXTURES r �� 4 r
PLAN CHECK FEE (507 PERMIT FEE)
POWER AUTHORIZED /1( /)
PERMIT ISSUING FEE 2 00 2 00 UTILITY CO NOTIFIED y 7( y �'
SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL Lp
ou JOSEPH C ROOHAN
TOTAL FEE SUPERVISING ELE CAL ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION cK M 0 CASH
�� 5 4:a APR 3 D 6 60~
AI�7-
IEEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE / /��