HomeMy Public PortalAbout4846 AGNES AVE_Electrical_8/28/1975_RECEPTACLES, OUTLETS, SWITCHES 76A663 CEBp610/74 APPLICATION FOR ELECTRICAL PERMIT L.I
r COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER ADDRESS ✓�
BUILDING AND SAFETY DIVISION VAC
LOCALITY (14
NEAREST OW S w
FOR APPLICANT TO FILL IN CROSS ST
OUTLETS NO EACH FEE OWNER OR
FIRM NAME:jZQSE'
RECEPT1 $ $ MAIL
LIGHT TOTAL FIRST 20 25 O� ADDRESS 20'4_0 A)l? r"r
[� y� CITY t-, 0032- TEL NO
SWITCH C.� OVER 20 f0 a 0 PLAN CHECK
LIGHTINGTOTAL FIRST 20 25 S APPLICANT
FIXTURES � f0
OVER 20 ADDRESS
_
RESIDENTIAL APPLIANCES CITY TEL NO
PERMIT
RANGE DRYER_WTR HTR APPLICANT
STA COOK DISP F A U ADDRESS
SPACE HTR AIR COND CIITY TEL NO
CLOTHES WASH DISHWASH LEGE NUMBER CLASS
FAN OTHER 100 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND HEATERS ETC HP KW KVA ELECTRICAL WIRING
SIZE B TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPER REGIBTERED AND/OR
0 — 1 100 LICENSED A8 REQUIRED BY LOB ANGELS DUNTY ANO STATE OF
CALIFORNIA OR THAI I AM THE LEGA OWNER OF THE ABOVE
1 — 10 800 DESCRIFED RESIDENT L ROPERTY CD
PERMITEE
10 — 50 500 SIGNATURE O
50 — 100 1000 DISTRICT 1p
ROC SED
a
100 — 500 1000 O Z
SIGN GAS SIGN AND ONE CIRCUIT 500 APPROVALB DATE INBPECTOR8810MATURE
TUBE OR
MARQUEE ADDITIONAL CIRCUITS 100 I TEMP POWER POLE
SERVICE NOTOVER 600 VOLTS OR 200 AMP 800 UNDERSLAB WORK
SERVI CEOVER 600 VOLTS OR 200 AMP 1000 ROUGH CONDUIT 6
TEMPSERVICE POLE &APPURTENANCES 500 WIRING
TEMP LIGHT OR RECEPT SYSTEM 800 FIXTURES .01
POWER AUTHORIZED A10 -1
UTILITY CO NOTIFIED
FINAL
PERMIT FEE (SUB TOTAL) NOTES ro, ?S^ ✓� a0
PLAN CHECK FEE Cr WS ICA ate,Q /v 07
PERMIT ISSUING FEE ` 800 00 COO/—
.
TOTAL FEE Q
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M o CAs
3 6 8r AUG 28 2 D 103 Q 69d
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
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