HomeMy Public PortalAbout5817AGNES AVE_Electrical (4) 76A663 CES06 4 68 APPLICATION FOR ELECTRICAL/ PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING J,
BUILDING AND SAFETY DIVISION ADDRESS ..J /
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUPERINTENDENT OF BUILDING LOCALITY I✓G
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
NO EACH FEE
$ $ OWNER
RECEPT _ MAIL
LIGHT TOTAL FIRST 20 20 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 I
STA COOK_DISP _F A U — COI4TRAC rOR
SPACE HTR AIR CONO
ADDRESS �t
CLOTHES WASH —DISHWASH CITY 11T L NO
FAN_OTHER 1 00 LICENSE NO CLASS ^/
MOTORS TRANSFORMERS RATING
IND HEATERS ETC HP KW KVA i HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
SIZE & TYPE OVER TO AND STATE THAT THE ABOVE 15 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
CALIFORNIA OR THAT I AM THE LEGAL OWN AND INTEND TO
10 — 50 5 00 RESIDE IN THE A D S RIPED R IDENTIAL PROeERTY
50 - 100 10 00 SIGNATURE L� O
OF PERMITTEE
U
100 - 500 15 00
DISTR GROUP ZO.NE/ PROCESS D BY o
SIGN
TUBE GOR AS SIGN AND ONE CIRCUIT 3 00 U
W
MARQUEE ADDITIONAL CIRCUITS 1 00 NOTES D_
N
Z
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00
SERVICE OVER 600 VOLTS OR 200 AMP 5 00
TEMP ERVICE VOL &APPURTENANCES 3 00 APPROVALS DATE INSPECTOR S SIGNATURE
r
zzzzJFAI,
(J TE POWER POLE
ICA j UND RSLAB WORK
ROU4H CONDUIT
PERMIT FEE (SUB TOTAL) WIF&AG
IXTURES
PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED
PERMIT ISSUING FEE 2 00 UTILITY CO NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1 00FINAL
TOTAL FEE JOgePC RO HAN
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK M o CASH PERMIT VALIDATION CK M o CASH
} � S167o APR 4 P, D 18o-
EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE