HomeMy Public PortalAbout5817AGNES AVE_Electrical (3) 76A663 CE806 4 68 APPLICATION FOR ELECTRICAL)PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEERBULDING
J
BUILDING AND SAFETY DIVISION ADIDRESS ( �G 1
JOHN A LAMBIE COUNTY ENGINEER r
COLEMAN W JENKINS SUPERINTENDENT OF BUILDINGLOCALITY
NEAREST
FOR APPLICANT TO FILL IN JCROSS ST
NO EACH FEE /
RECEPT $ $ 1OWNER
� MAIL
1
LIGHT TOTAL FIRST 20 20 4 ADDRESS
SWITCH_ OVER 20 10 CITY TEL NO
PLAN CHECK
LIGHTING �TOTAL, FIRST 20 20 APPLICANT
FIXTURES OVER 20 10
ADDRESS
RANGE—DRYER—WTR HTR _ CITY TEL
STA COOK_DISP F A U — COI,,TRAC rOR y Lc_
SPACE HTR AIR COND
ADDRESS
CLOTHES WASH —DISHWASH CITY L T L NO +
FAN—OTHER 1 00 i
LICENSE NO / CLASS (��
MOTORS TRANSFORMERS RATING
IND HEATERS ETC HP KW KVA I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING
0 - 1 1 00
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
1 - 10 3 00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CAL: HIA OR THAT 1 AM THE LEGAL OW R OF AND INTEND TO
10 - 50 5 00 RESIDE IN THE ABOVE
DESCR IPED ESIDEN IAC PROPERTY
50 - 100 .1000 SIGNATURE L-4— C
OF PERMITTEE f AU
loo - 500 15 0o DISTRICT,I 0 GRaUP ZO E I PROCESSED BY p
SIGN GAS SIGN AND ONE CIRCUIT 3 00 p ~
TUBE OR w
MAROU EE ADDITIONAL CIRCUITS 1 006
NOTES avwA Ze� �
� Z
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00 O,1 l
SERVICE OVER 600 VOLTS OR 200 AMP 5 00
11225w 1
TEMP SERVICE POLE &APPURTENANCES 3 00 APPROVALS ATE INSPECTOR S SIGNATURE
TEMP POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
PERMIT FEE (SUB TOTAL) WIRING
FIXTURES
PLAN CHECK FEE (507 PERMIT FEE) ^ POWER AUTHORIZED
PERMIT ISSUING FEE 200 11 O'D UTILITY CO NOTIFIED4
L'
SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL
TOTAL FEE t JOSEPH C ROOHAN
SUPERVISING ELE ICAL ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION cK M o CASH
l Ar, 9 2 26-%o APR 3 ? D 4 20- r
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE /