HomeMy Public PortalAbout9520 BLACKLEY ST_Electrical__ 76A663-080611/70 •APPLICATION FOR ELECTRICAL ERMIT
COUNTY OF LOS ANGELES FADDRESSNG r�/�
DEPARTMENT-OF COUNTY ENGINEER C7.,5-.Z � fry -��I tz-_F 15,-r,
BUILDING AND SAFETY DIVISION
COLEMAN W. JENKINS SUPERINTENDENT OF BUILDING ITYNEARE
FOR APPLICANT TO FILL IN , S T. 6ULo. r
OUTLETS NO EACH FEE - Z7 Cl, i ^�/�
$ $ OWNER
RECEPT._ MAIL-
LIGHT_ TOTAL
FIRST 20 y P5, ADDRESS
OVER 20 CITY - TEL NO
SWITCH 10 PLAN CHECK -
FIRST 20 25 APPLICANT
LIGHTING TOTAL
OVER,20 ADDRESS
FIXTURES 10
APPLIANCES CITY TEL NO.
PERMIT r
RANGE DRYER_WTR HTR APPLICANT a L�lu e
STA. COOK DISP F A U _/_ ADDRESS•
SPACE HTR AIR COND. CITY TEL NO.
CLOTHES WASH DISHWASH. LICENSE NO CLASS.
' FAN OTHER 100 1-HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATI NO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND HEATERS, ETC HP KW KVA ELECTRICAL WIRING
SIZE IN TYPE OVER TO
'I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I A THE LEGAL OWNER OF, AND INTEND TO
CL
TO� 1 -•10 300 RESIDE IN, THE O L DE CRIBED�ESID NTIA OPERTY
SIGNAT E C2
10 - 50 , 500 OF PERMRITTEE �C'� v ' U
d'
- SO -•100 1000 DISTRICTNO CLASS ESS BY O
100 - 500 1500 SD$ ��
H
;SIGN, GAS SIGN AND ONE CIRCUIT 5001 ' NOTES: Z
TUBE, OR 1 _ - -
-MARQUEE ADDITIONAL CIRCUITS 100 '
SERVI CENOT OVER 600 VOLTS OR 200 AMP 300 O
APPROVALS DATE INSPECTOR'S SIGNATURE
SERVICEOVER 600VOLTS OR 200AMP 1000
TEMP POWER POLE ;
TEMP.SERVICE,POLE, &APPURTENANCES 500
UNDERSLAB-WORK
TEMP LIGHT OR RECEPT SYSTEM 300
ROUGH CONDIUT
WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FEE (SUB'TOTAL) ,
UTILITY CO NOTIFIED
PLAN CHECK FEE c
�� FINAL / 1-7
PERMIT ISSUING FEE 300 JOSEPH C. ROOHAN
TOTAL FEE SUPERVISING ELECTRICAL EN GI NEEP,
PLAN CHECK VALIDATION' CK M O CASH PERMIT VALIDATION CK M 0 CASH
Al:oi ` 5s,—, 16 ? D 1 0:75~
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE ,
DBS-SAft•59 APPLICATION FOC • ELECTRIC PERMIT
DBS-5A
DIVISION OF BUILDING AND SAFETY
DepDrhaent of County Engineer BUILDING (—j
�j n Q� nC�� r
Nmm
County of LOS Angeles ADDRESS ✓ [J /r .0
JOHN A. LAMBIE, COUNTY ENGINEER ^�� y
CASSATT D. GRIFFIN. SUPT OF BUILDING LOCALITY /E/VJl��F
FOR APPLICANT TO.FILL IN CEAREST OSS ST.. LU L
PERM FEES
NUMBER OWNERC. QIP v-
LIGHT OUTLETS MAILn
RECEPTACLES ' ADDRESS
WALL SWITCHES FEE CITY Pl G TEL. NO.
TOTAL OUTLETS @ 52 $ ELECTRICIAN Z Ve -
ELEC. RANGES 25
ADDRESS
ELEC. HEATERS 25 /
KW EA CITY ��,� Gj TEL. NO.
STATE
FIXTURES g LICENSE-NO.
MOTORS DISTRICT NO. JGROUP� ZONE I READY FOR INSPECTION
NUMBER HORSEPOWER FEE in 1
NEW MVD. HP OVER INC. EACH
1�2 @ LE38 $ .zs INSPECTION RECORD '
Yz 2 .50
2 5 1.00
5 15 1.50
15 50 2.50
50 1 200 3.00
MISC.
NO. SIGNS NO.TRANS.
NO. SIGNS NO. LAMPS
FOR EACH PERMIT:
WIRING $f.00 I 0
FIXTURES $1.00
SUPPLEMENTARY .50 APPROVALS
TOTAL FEE $ DATE INSPECTOR'S SIGNATURE
I HEREBY ACKNOWLEDGE,THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING Cs
ELECTRICAL WIRING.
I HEREBY CERTIFY THAT IkMQYERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY� SCOUNTY AND STATE OF
CALIFORNIA OR THAT I A I G 'OWNER OF THE ABOVE POWER
DESCRIBED RESIDENTIAL P
SIGN --E UTILITY CO.NOTIFIED
OF FINAL l5
JOHN A.LAM7IE oUNTY ENvd. ER VALID'A SAT ARTHUR C.VEIT.CHIEF ELECT. INSPECTOR
CK MO �
In
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vv I �.�
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D88• 3 APPLICATION- FOR ELECTRIC PERMIT �.
9•'35
DMSION OF BUILDING AND SAFETY
Deportment of County Engineer
County of Los Angeles BUILDING ��� � �ACIt'L ��
WM.J. FOX, COUNTY ENGINEER ADDRESS
` CASSATT D.GRIFFIN. SUPT OF BUILDING '
LOCALITY 2 /0LL= C/ T
FOR APPLICANT TO FILL IN NEAREST Ir y, !
PERMIT FEES CROSS ST.
NUMBER EACH FEE _ OWNER
• /V
LIGHT OUTLETS /-
MAIL
RECEPTACLES I ADDRESS C' 3A 19 C ltl R
WALL SWITCHES /-
TOTALOUTLETS 5¢ S d CITY �LE T EL NO
ELEC RANGES 25 ELECTRICIAN I jp
C
_ELEC HEATERS 25 07 ADDRESS `// J7• f
KW EA CITY +�- / TEL NO Cl
FIXTURES 5 'S LICENSE NO
NUMBER OF LIGHT CIRCUITS41c —. ` - DISTRj TNO. GROUP ZONE I READY FOR INSPECTION
NUMBER OF RECEPTACLE CIRCUITS
MOTORS
NUMBER I HORSEPOWER INSPECTION RECORD
FEE
NEW MVD HP OVER INC EACH
V2 a LESS S .25
1/2 2 50
2 5 1 00
5 15 1.50
15 502 50
50 200 500
MISC. �Cr
NO SIGNS NO-TRANS -NO SIGNS NO LAMPS
FOR EACH PERMIT:
WIRING 51.00
FIXTURES $100jAND/
SUPPLEMENTARY - 50 APPROVALS
TOTS L FEE g DATE INSPECTORS SIGNATURE
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APCONDUIT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TWITH ALL COUNTY ORDINANCES AND STATE LAWS REWIRING I1• 1SELECTRICAL WIRING.1HEPEBY CERTIFY THAT 1 AM PROPERLY REGISTEREFIXTURES
LICENSED AS REQUIRED BY.LOS COUNTY ANDCALIFORNIA OR THAT I AM L OWNER OF TPOWER
DESCRIBED RESIDENTIAL PROPUTILITY CO. NOTIFIEDSIGNATURE OFPERMI slFINALWILLIAM J. FOX, LINTY ENGINE ATION A. C. VEIT.CHIEF ELECT. INSPECTOR
1 3 0 � DEC28 ' 2 3.0 0 �
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