HomeMy Public PortalAbout9526 BLACKLEY ST_Electrical__ DBS-SA I1-8B APPLICATION FOR ELECTRIC PERMIT - g
DBS-SA
DIVISION OF BUILDING AND SAFETY
Depoxtmeat of County Engineer BU77777
.County Of LOS Angeles AD
JOHN A. LAMBIE,COUNTY ENGINEER
CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL"10IN NEAREST
PERICT FEES c oss ST. �•+
NUMBER OWNER
LIGHT OUTLETS MAIL
RECEPTACLES ADDRESS 4da-flaA Q_
WALL SWITCHES FEE CITY TEL.NO.
Llb- TOTAL OUTLETS @ 5Q $ 11-3.6
ELECTRICIAN
ELEC. RANGES 25
ADDRESS
ELEC HEATERS 25
CITY TEL.NO.
KW EA
STATE
FIXTURES 5 LICENSE NO.
MOTORS DISTRICTN. I GROUP I ZONE I READY FOR INSPECTION
NUMBER HORSEPOWER ,FEE A-
NEW 1/
MVD HP OVER INC. EACH INSPECTION RECORD
Yr&LESS $ .25
Yz 2 .50 I tb 51 �11tG� QaSI-� •� t.�T
2 5 1.DD
5 15 1.50
15 50 2.50 a
50 200 5.00
misc.
0
NO. SIGNS NO.TRANS.
NO. SIGNS NO. LAMPS
FOR EACH PERMIT: �ry
WIRING $1.00 v v
FIXTURES $1.00
SUPPLEMENTARY .50 APPROVALS
TOTAL FEE S 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 Z 'I
ELECTRICAL WIRING. _
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE POWER -1
DESCRIBED RESIDENTIAL PROPERTY.
SIGNATURE UTILITY CO.NOTIFIED S l
_
OFPERMITTE - FINAL -�
JOHN A.LAMBIE,COUNTY ENGINEER VALIDATION ARTHUR C. EIT,CHIF.ELeCT. INSPECTOR
CK MO CASH
.1 .s 9,9 Z9 OCT 31 2 .8 0
76A663-CE806v9-67 APPLICATION FOR ELECTRICAL PERMIT//
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING /
BUILDING AND SAFETY DIVISION ADDRESS C ,L&
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS,'SUPERINTENDENT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
VNO.NO AC FEE
RECEPT $ $ OWNER _
MAIL _
LIGHT _7� TOTAL FIRST 20 20 ADDRESS
SWITCH_ OVER 20 10 CITY TEL. NO./
LIGHTING TOTAL FIRST 20 20 -� CONTRACTOR
FIXTURES OVER 20 10- ADDRESS
RANGE—DRYER—WTR HTR.— CITY ZTEL N
STA COOK _30ISP/ F.A_U
LICENSE NO ,
I HEREBY ACKNOWLEDGE T AT I HAVE READ THIS APPLICATION
SPACE HTR AIR GOND +, 1+ A ND,STATE•`THAT,THE ABOVE, IS CORRECT AND AGREE TO COMPLY
CLOTHES WASH ISH WAS H. WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
(/g ELECTRICAL WIRING
FAN OTHER `- 1 00 ! 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR,
LICENSED AS REQUIRED BY LOS_ ANGELES COUNTY AND STATE OF,
MOTORS,TRANSFORMERS RATING CALIFORNIA OR THAT I AM HE EG AL OWNER OF, A D INTEND TO
IND HEATERS, ETC HP KW KVA RESIDE IN, THE =ED RE IDE NT PROP RTY
SIZE & TYPE OVER TO SIGNATURE
O - 1 1 00 IF PERMITTEE d
1 - 10 3 00 DISTRICT` .-GR Z P O -. �`ED U
1 0 - 50 5 00 C✓ �� 0
50 - 100 10 00 NOTES:
100 - 500 15 00
N h
SIGN,GAS SIGN AND ONE CIRCUIT 3 00 Jt.4i .d / Ad�i�l /37.�`C. Z
TUBE, OR
MARQUEE I ADDITIONAL CIRCUITS 1 00 —
SERVICE NOT OVER 600 VOLTS OR 200 AMP 1.
.7 2 00
SERVICE OVER 600 VOLTS OR 200 AMP 5 00
TEMP SERVICE, POLE, &APPURTENANCES 3 00 ,
APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP. POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
.�.�y WIRING
ISSUING FEE 2 00 I'l1'
FIXTURES
SUPPLEMENTARY ISSUING FEE 1 00
POWER AUTHORIZED /
PERMIT FEE UTILITY CO NOTIFIED
PLAN CHECK FEE (50% PERMIT FEE) FINAL
TOTAL FEE JOSEPH C. ROOHAN
SUPERVISING ELEC CAL ENGINEER
PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION cK M O CASH
-2 5-0.7.- JAN 9 , 2 0 1 1.8 p N
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
DEPA SA 2SM SETS 113-47
AHITMENT OF BUMDM AND SAFE A"LICATION FOR. PFI
COUMrY OF LOS ANGELS Ei TIL. Ei CT IC 1
WM. J. FOX, C IEF E (NEER
�GL�iI/ igQ�j'J� DISTRICT NO. G76l9a7i OME y/ePERMIT 110.
Q NAPE
\ U ADDRESS I4(/O dc' /r/,Al� �� �✓ C/ ��O
CITYf'p.F/L�L TEL.NO. RECEIVED BY READY FOR DATE ISSU D
yl FIRST INSPECTION
COUNTY
W CERT.NO. TEXPIRES
APPLICANT FILL IN IEAYD.Y OUTLEVE ) POR'nON ONLY
DESCRIPTION OF WORD AJ DDRESS -2T/C) /�GI�CP�L`L,�✓ S7
PLUMBER OF OUTLETS ON CIRCUITS LOCALITY /�fT/�Lo� CI T y /
LOCATION BY ROOMS
NEARESTS �LodE�.0
LIGHT OUTLETS SW. PLUGS potT CROSS SST.
CIRCUIT Ai I B I C D E E I G 11 w NAME
7 / Z MAIL
ADDRESS
O
CITY TEL.NO.
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS
/LNGELES COUNTY GLRTIFIPATE OF Q/UALIFICATIOO 1..
ELECTRICIAH.
I AM THE LEGAII..OWNER OF THE PROPERTY DESCRiSM
ABOVE
OWNER.
COMECTIONS
Q
z
cD
C3
OTAL
NO. OF OUTLETS $ I �� AFI'RO"LS
NO. OF FIXTURES $ DATE INSPECTOR'S NAME
NO. OF MOTORS H.P. $ CONDUIT .9
NO. OF SIGNS TRANS. Pu WIRING ir-
NO. OF RANGES OR HEATERS $ FIXTURES
MISCELLANEOUS $ POWER
PERMIt FEE $ UTILiTYCO.NOTIFIED /
TOTAL FINAL /`7 %(/,5