HomeMy Public PortalAbout9683 BLACKLEY ST_Electrical__ l '°")r- APPLICATION F ELE& ICAC PERMIT
COUNTY OF LOS ANGELES
wARTMENT OF COUNTY ENGINEER JOB
EUILDING AND SAFETY DIVISION ADDRESS
�. LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
OUTLETS NO. EACH FE OWNER OR
FIRM NAME
RECEPT� $ $ MAIL
LIGHT TOTAL
f j FIRST 20 25 "D
SWITCH I� (� 10 CITY TEL. NO.
OVER 20 e�
,�.•� PLAN CHECK
LIGHTING FIRST 20 25 .12, 111-0 APPLICANT
TOTAL
FIXTURES
OVER 20 .10 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL. NO.
PERMIT 12 -„�-
RANGE DRYER_WTR. HTR. APPLICANT -yl✓'{ �
STA, COOK DISP, F.A.U. ADDRESS
SPACE HTR. AIR COND. CIT TEL. NO.
CLOTHES WASH. DISH WAS H. ICEE OR
REG.NUMBER GAJ Z CLASS. Id
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 WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING.
SIZE & TYPE OVER TO
I HEREBY CERTIFY THAT-1 AM PROPERLY REGISTERED AND/OR
0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAI I AM THE LEGAL OWNER THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. -
1 - 10 3.00 v
PERMITEE r
10 - 50 5.00 SIGNATURE p
H
50 - 100 10.00 C')
DISTRICT N0. SED BY O..W
100 - 500 15.00 �—` ✓) N
LF z
SIGN, GASSIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECT 'S SIGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE
SERVI CENOT OVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK
SERVI CEOVER 600 VOLTS OR 200 AMP 10.00 ROUGH CONDUIT
TEMP SERVICE,POLE, &APPURTENANCES 5.00 WIRING
TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES _
POWER AUTHORIZED
UTILITY CO. NmTIF1ED yy °•9 i
FINAL ' rS / A4f� ''e�f' -.�•
PERMIT FEE (SUB TOTAL) 3 V v NOTES;
PLAN CHECK FEE
PERMIT ISSUING FEE 3.00 3
TOTAL FEE
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION y CK M.0. CASH
1 1 4 NOV. � 2 1 6.0 0
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
.'&:"i t'
76A663-C - 11-71 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS eJ
LOCALITY 742
C
NEAREST
FOR APPLICANT TO FILL IN CROSS ST,
OUTLETS NO. EACH FEE
OWNER
RECEPT._ $ $ MAIL
LIGHT TOTAL
FIRST 20 0, 25, 6-0 ADDRESS
SWITCH OVER 20 L 10 (�� CITY TEL. N0.
lwp� PLAN CHECK
LIGHTING FIRST 20 25 ti 1 APPLICANT
TOTAL c/
OVER 20 ADDRESS
FIXTURES .10
RESIDENTIAL APPLIANCES CITY TEL. NO.
PERMIT
RANGE DRYER WTR. HTR. APPLICANT
r
STA. COOK DISP. F.A.U. ADDRESS
SPACE HTR. AIR COND. CITYt77T' C TEL. NO.
CLOTHES WASH. DISHWASH. LICENSE N0. 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 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
0 - 1 100LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM.THE LEGAL OWNER OF, AND I TEND TO 0
1 - 10 3.00 RESIDE IN, THE ABOVE DESCR BED RESIDE TIAL OPER Y. i
V
SIGNATURE
10 - 50 5.00 OF PERMITTEE 0
50- 100 10.00 F"
DISTRICTNO. CLASS ZON PROLE SED BY u
100 - 500 15.00 J O� , �
N
SIGN, GAS =SIGN ONE CIRCUIT 5.00 NOTES: �3 Q ?
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00
SERVICE NOTOVER 600 VOLTS OR 200 AMP + 3.00
J
APPROVALS DATE INSPECTOR'S SIGNATURE
SERVI CE OVER 600 VOLTS OR 200 AMP 10.00
TEMP.POWER POLE
TEMP SERVI CE,POLE, &APPURTENANCES 5.00
UNDERSLAB WORK
TEMP LIGHT OR RECEPT. SYSTEM 3.00
ROUGH CONDIUT
WIRING ! t-, 73-
FIXTURES 10
PERMIT FEE (SUB TOTAL) POWER AUTHORIZED
-11171-17�3
UTILITY CO. NOTIFIED
PLAN CHECK FEE _ +;7w7' /
FIN 2
PERMIT ISSUING FEE 3.00 �
TOTAL FEE a
PLAN CHECK VALIDATION CK. M.0. CASH PE MIT VALIDATIONCK. � .O. CASH
r . AUG 21 ? D 1 3904
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
4 76A663 DBS 5A 3-513 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TFILL IN DISTRICT- NO. GROUP ZONE PERMIT NO.
ELECTRICIAN _
RECEIVED BY READY FOR DATE ISSUED
ADDRESS -31,-
FIRST INSPECTION
CITY ,.f7..f.Sw^•-",.iTJp� TEL NOVL1 �y 6 -3 / p A-
COUNTY LICENSE N0. EXPIRES - BUILDING
PERMIT FEES = ADDRESS
FEE
NUMBER EACH LOCALITY
LIGHT OUTLETS NEAREST
D
RECEPTACLES CROSS ST. p
WALL SWITCHES OWNER
TOTAL OUTLETS S. MAIL - ✓.
ELEC. RANGES 25 ADDRESS
ELEC. HEATERS 25
FIXTURES � S � CITY TEL. NO.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
MISC. APPLICATION AND STATE THAT THE ABOVE IS CORRECT
NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING.
MOTORS 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS
NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
NEW MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED
ABOVE-V2 6 LESS $ 25
SIGNATURETTEE
V2 2 .50
2 s 1.oD INSPECTION RECORD
5 is 1.50
is 50 2.50
50 200 5.00
_ 200 Boo 10.00 o J
Soo 1000 15.00 Z
OVER 1000 20.00 Is
M.O. SET/FREQ. CHANGER-HP
WELDERS:AC-KVA O
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75% OR DRIB.)
MOVED MOTORS (75% OF DRIB.)
MISC.
SIGNS
NO. NO.TRANS.
APPROVALS
NO: NO. LAMPS
FOR EACH PERMITi DATE INSPECTOR'S NAME
WIRING $1.00 O dCONDUIT
FIXTURES $1.00 Q WIRING /
SUPPLEMENTARY .50 FIXTURES
POWER //e
TOTAL FEE !� UTILITY CO.NOTIFIED���T%/a'"-o
FINAL ra�tf � J" Ck