HomeMy Public PortalAbout5002ALESSANDRO AVE_Electrical (3) 71lAoe3 CLSOG 468 'APPLICATION FOR ELECTRICA(PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING f
BUILDING ,AND SAFETY DIVISION ADDRESS C7d Gas •vclCo UC
JORN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUPERINTENDENT OF BUILDING LOCALITY /`
NEAREST oll
FOR APPLICANT TO FILL IN CROSS ST
NO EACH FEE 1
[FIXTURES
CEPT $ $ OWNER / r C"iOCe
MAIL
GHT TOTAL FIRST 20 20 ADDRESS
ITCH OVER 20 10 CITY �h C TEL NO T
PLAN CHE
GHTING TOTAL FIRST 20 20 APPLICANT
OVER 20 10 ADDRESS
t
RANGE_DRYER—WTR HTR — CITY TEL NO
STA COOK_DISP _F A U — COIJTRAC rOR
SPACE HTR AIR COND ADDRESS
CLOTHES WASH —DISHWASH CITY TEL NO
,FAN—OTHER 1 00 LICENSE IJO 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 — I 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 OWNER OF AND INTEND TO
10 — 50 5 00 RESIDE IN THE ABOVE DESCRIP RESIDENTIA PROPERT
SIGNATURE CL
50 — 100 10 00 OF PERMITTEE U
100 — 500 15 00
DISTR CGFa,O�UP Z N PROC SSED BY o
TUBESIGN GOR AS SIGN AND ONE CIRCUIT 3 00 C y� , v
nIN
LIJ
MARQUEE ADDITIONAL CIRCUITS 1 00 NOTES r
N
Z
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00 U
SERVICE OVER 600 VOLTS OR 200 AMP 5 00
TEMP SERVICE POLE &APPURTENANCES 3 00 APPROVALS DATE INSPECTOR S SIGNATURE
TEMP POWER POLE
} UNDERSLAB WORK
ROUGH CONDUIT
WIRING
PERMIT FEE (SUB TOTAL)
FIXTURES
PLAN CHECK FEE (507 PERMIT FEE) POWER AUTHORIZED
PERMIT ISSUING FEE 200 UTILITY CO NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEEI 1 00 VV FINAL
TOTAL FEE "2 JOSEPH 6 ROOHAN
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH_ PERMIT VALIDATION CK M 0 1cASH
0claSLAr1 2 4 2% JLL 31 2 D 2 20-
SEE
EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE