HomeMy Public PortalAbout5019ALESSANDRO AVE_Electrical (2) 76AJ63 CE806 3 69
APPLICATION FOR ELECTRICAL PERMIT
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COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDINGX I� /!
BUILDING AND SAFETY DIVISION ADDRESS U /
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUPERINTENDENT OF BUILDING LOCALITY
1=111
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
NO EACH FEE
$ $ OWNER
RECEIPT MAIL
LIGHT_L TOTAL FIRST 20 20 ADDRESS
CITY TEL NOS:?lZ
SWITCH_ OVER 20 10 PLAN CHECK
LIGHTING Ll_
TAL FIRST 20 20 � APPLICANT
FIXTURES OVER 20 10 ADDRESS
1
RANGE DRYER WTR HTR CITY TEL NO
STA COOK DISP F A U CONTRACTOR
SPACE HTR AIR COND ADDRESS
CLOTHES WASH _DISHWASH CITY TEL NO
FAN OTHER 1 00 LICENSE NO CLASS
MOTORS TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
IND HEATERS ETC HP KW KVA AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING
0 - 1 1 DO 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
ICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATEOF >_1 - 10 3 OO CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO O.O
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY
10 - 50 500 ` 0
SIGNATURE
50 - 100 10.00 OF PERMITTEE
O
100 - 500 1500 DISTRICT NO GROUP ZONE PRO SE Y I
W
SIGN GAS SIGN AND ONE CIRCUIT 3 00 li N
("
TUBE OR Z
MARQUEE ADDITIONAL CIRCUITS 1 00 NOTES
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 INSPECTORS 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 2 00 UTILITY CO NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL
TOTAL FEE JOSEPH C ROOHAN
SUPERVISING ELECTR L ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M 0 CASH
4QMSEU v 7N DEC 1 6 2 D 240-
SEE
E BACK OF APPLICATION FOP COMPLFTF FFE G HFDIII F