HomeMy Public PortalAbout5833ALESSANDRO AVE_Electrical L 1-t-
76A 663 C�- CE806B 1'2/75
APPLICATION FOR ELECTRICAL PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN JOB
New Residential Bldgs.&Pools EACH NO. FEE ADDRESS J �.S '✓
1 &2 Finaily Sq. Ft. $ — $ LOCALITY
Multi-family Sq. Ft. — NEAREST
CROSS ST.
Residential Swimming Pools OWNER OR
FIRM NAME,II�i�'i
Outlets: Light, Switch&Receptacle MAI L pp
p 33,
First 20 ADDRESS
Additibnal CITY .y�►t Tel. No.
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 d
REG. NUMBER Class.
Disp. A.C.
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY 0
ower Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
Size&Type HP, KW, KVA,or KVAR ELECTRICAL WIRING. W
o_
Up to 1 Incl. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR C/1
Over 1 to 10 Incl. LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
Over 10 to 50 Incl. DESCRIBED RESIDENTIAL PROPERTY,
Over 50 to 100 Incl. PERMITEE
Over 100 SIGNATURE
DISTRICTNO. PR CESS B
Services „{ tl �!
0-200 Amp. Under 600 V ll 0 (>
201 - 1000 Amp. Under 600 V APPROVALS DATE INSPECTOR'S
SIGNATURE
Over 1000 Amp.or Over 600 V
TEMP. POWER POLE
Temp. Power Pole&Appurtenances UNDERSLAB WORK
Sign with One Branch Circuit
ROUGH CONDUIT
Additional Sign Branch Circuits I
(Other) WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FEE (Sub-Total) UTILITY CO.NOTIFIED ,i
PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL
PERMIT ISSUING FEE
NOTES��.��
� r;
TOTAL FEE CIO
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH