HomeMy Public PortalAbout5717 PRIMROSE AVE_Electrical_2/13/1978_OUTLETS LIGHT FIXTURES 76A663-CE806 10.72 APPLICATION FOR ELECTRICAL P MIT
'COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER goDREss r T ,� y" ✓
BUILDING AND SAFETY DIVISION
LOCALITY
NEAREST i
FOR APPLICANT TO FILL IN CROSS ST!FRECEPT.7
TS NO. EACH FEE OWN NAfR$ $ MAIL
FIRST 20 25 : , �� ADDRESSTOTAL CITY TEL. NO.
! OVER 20 10
PLAN CHECK
FIRST 2025 - APPLICANT
LIGHTING TQJAL
-CC ADDRESS
OVER 20
FIXTURES � aJ 10
RESIDENTIAL APPLIANCES CITY TEL. NO.
PERMIT
RANGE DRYER WTR. HTR._ APPLICANT
STA. COOK DISP. F.A.U. ADDRESS /' •' '+'""' "�
SPACE HTR, AIR COND. CITY ;/ Ir T TEL. NO.
CLOTHES WASH. DISHWASH. LICENSE OR
REG. NUMBER CLASS.
FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING W ITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING.
SIZE & TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR r
0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE O
1 - 10 300 DESCRII'.ED RESIDENTIAL PROPERTY. U
W
PERMITEE - - --1
10 - 50 5.00 SIGNATURE �+-
50 - 100 10.00
DISTRICT N0. PROG�SSED By.
100 - 500 15.00CL
O
SIGN, GAS
j
r
SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTOR'S SIGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE
SERVI CENOT OVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAS WORK
SERVICEOVER600VOLTS OR200AMP 10.00 ROUGH CONDUIT
TEMPSERVICE,POLE, &APPURTENANCES 5.00 WIRING
TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES
POWER AUTHORIZED
UTILITY CO. NOTIFIED
FINAL
PERMIT FEE (SUB TOTAL) NOTES:
PLAN CHECK FEE
PERMIT ISSUING FEE 3.00
TOTAL FEEj ?,,J
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE