HomeMy Public PortalAbout9210 BLACKLEY ST_Electrical__ 76A669C- CE8088 12/76 APPLICATION FOR ELECTRICAL PERMIT
BUILDI AND SAFETY ISIONqr
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FOR APPLICANT TO FILL IN JOB Z I` ,�C/ I
FReesidential Bldgs & Pools EACH NO FEE ADDRESS Ls4C l-
Sq Ft $ — $ LOCALITYq Ft — NEAREST
CROSSST �/ d/N/ 7-M S
wimming Pools
OWNERM /✓I ou.�T'o
FIRM NAME ' f
Outlets Light,Switch & Receptacle ADDRESS .,11(J x AC'/(C
First 20 Ov
r
Additional CITY C"7-/Tel No
PLAN CHECK �� C�dN S�
APPLICANT -�i9 �'
Lighting Fixtures / /r
First 20 f� V ADDRESS 13 0 ! S, 6j.4/46 V
Additional -
- - - - - - - - CITY�II1J 6'A0 00CC Tel No gV"`J��•2
PERMIT
Fixed Appliances Not Over 1 HP APPLICANT �q �' /�/L Cc"/✓ 7—
Range
Range Heater_ D W ADDRESS
Oven Dryer W M
Top FAU WH CITY Tel No
�7 / d
Hood Fan REG LICENSE NUMBER r,C 6 131 Class p
D1sp A C v
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY O
Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING V
Size&Type HP, KW, KVA,or KVAR ELECTRICAL WIRING
W
a
Up to 1 InCI I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR N
Over 1 to 10 Incl LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM TH GA NER OF THE ABOVE
Over 10 to 501ncl DESCRIBED RESIDE AL ROP RT Y
Over 50 to 100 incl PERMITEE
Over 100 SIGNATURE
Services
DISTRICT NO O SSED Y
0-200 Amp Under 600 V 5v - 0
201 1000 Amp Under 600 V APPROVALS DATE PECT 'S
Over 1000 Amp or Over 600 V SIGNATUURRE
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 42
PLAN CHECKING FEE (One Fourth Permit Fee) FINAL
PERMIT ISSUING FEE
NOTES
TOTAL FEE
PLAN CHECK VALIDATION CK MO CASH PERMIT.VALIDATION M o CASH
1 0 .34 MAY 2 2 i 2 3,2 5 d98
L u
76go63-`E806 10/72 APPLICATION OR ELE&RICAL PERMIT
• COUNTY OF LOS ANGELES
• DEPARTMENT OF COUNTY ENGINEER ADDRESS Q �j
BUILDING AND SAFETY DIVISION
LOCALITY Cl 7
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
FIXTURES
TS NO EACH FEE OWNER OR / Go•�� `
$ $ FIRM NAME M [�
FIRST 20 .20 ADDRESS V G
MAIL
LIGHT TOTAL TOTAL 25
OVER 20 y 1p
�O CIT PLAN CHECK TEL NO
FIRST 20 17 P5 APPLICANT
TOTAL ADDRESS
OVER 20 ip
RESIDENTIAL APPLIANCES CITY TEL NO
PERT
/
RANGE DRYER_WTR HTR APPLIICANT 614(1/J
STA COOK DI �F A U ADDRESS
i
SPACE HTR AIR COND CITY TEL NO
CLOTHES WASH DISHWASH LICENSE ORCLASS ' D
REG NUMBER
FAN OTHER 100 I HEREBY ACKNOWLEDGE THAT-1 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 & TYPE OVER -TO -
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
O — 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAI I AM THE LEGAL OWNER OF TH ABOVE r
1 — lO 300 DESCRIPED RESIDENTIAL P PER Y Cl.
O
PERMITEE • U
10 - 50 500 SIGNATURE
O
50 - 100 1000 C_")DISTRICT NO PROCE ED BY
t d
100 - Soo 1500
SIGN GAS SIGN AND ONE CIRCUIT 500 APPROVALS DATE INSPEC 'S SIGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 100 TEMP POWER POLE
SERVICE NOTOVER 600 VOLTS OR 200 AMP 300 UNDERSLAB WORK
SERVICEOVER 600 VOLTS OR 200AMP 1000 ROUGH CONDUIT
TEMP SERVICE,POLE, &APPURTENANCES 500 WIRING
TEMP LIGHT OR RECEPT SYSTEM 300 FIXTURES
POWER AUTHORIZED
UTILITY CO NOTIFIED
FINAL
PERMIT FEE (SUB TOTAL) NOTES
PLAN CHECK FEE
PERMIT ISSUING FEE 300
TOTAL FEE r
PLAN CHECK VALIDATION CK M 0 CAS PERMIT VALIDATION cK M O CASH
33-2 vio 14 2 0 25.05A2
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE