HomeMy Public PortalAbout5760ALESSANDRO AVE_Electrical (2) 76A66t3C CEE806B 12/75 APPLICATION FOR ELECTRICAL PERMIT
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BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN ,JOB
New Residential Bldgs & Pools
EACH NO FEE ADDRES
1 &2 Finaily Sq Ft $ — $ LOCALITY
Multi family Sq Ft — NEAREST
CROSS ST
Residential Swimming Pools OWNER OR
FIRM NAME
Outlets Light Switch&Receptacle MADI L
First 20 ADRESS
Additional CITY Tel No �3
PLAN CHECK
Lighting Fixtures APPLICANT
First 20 ADDRESS
Additional
CITY Tel No
PERMIT
Fixed Appliances Not Over 1 HP APPLICANT
Range Heater D W ADDRESS
Oven Dryer W M
Top FAU W H CITY Tel No
Hood Fan LICENSE OR i it O
Disp AC REG NUMBER C;t 3 a-0 �` Class oL
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION Q
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING LL!
Size&Type HP KW KVA or KVAR ELECTRICAL WIRING N
U to 1 Incl
P 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
/I Over 1 to 10 Incl LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF TME ABOVE
Over 10 to 50 Incl DESCRIBED RESIDENTIAL199PER Y
1
Over 50 to 100 Incl PERMITEE
Over 100 SIGNATURE
DISTRICT NO CE D BY
Services C)
0 200 Amp Under 600 V (/
201 1000 Amp Under 600 V APPROVALS ATE INSPECTOR S
SIGNATURE
Over 1000 Amp or Over 600 V
TEMP POWER POLE
Temp Power Pole&Appurtenances UNDERSLAB WORK
Sign with One Branch Circuit
Additional Sign Branch Circuits ROUGH CONDUIT
(Other) WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FEE (Sub Total) UTILITYCO NOTIFIED 7
PLAN CHECKING FEE (One Fourth Permit Fee) FINAL
PERMIT ISSUING FEE
NOTES
ITOTALFEE 9 0_6
PLAN CHECK VALIDATION CK MO CASH PERMIT VALIDATION CK MO ASH
914 tp 2 0 9.00m