HomeMy Public PortalAbout9141 BROADWAY_Electrical__ ,S' •
76AW CE-806(11 78) pp PPUCppN FOR
ELECT - aA� PEpI7
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COUNTY OF LOS ANGELES BUILDING APO SAFETY /1
FOR APPLICANT TO FILL IN JOB /
New Residential Bldgs.&Pools EACH NO, FEE ADDRESS
I &2-Family,Sq. Ft. $ .025 — $ LOCALITY
MultifamilySq. Ft. .02 — NEAREST
Revdential Swimming Pools 25.00 OWNER ORIT -
FIRM NAME F
Outlets: Re Light 4— AIL
�T �_ First 20 .50 ADDRESS
Total No.aAdditional .30ITY ' Tel. No..Ii T-e-Y _
PLAN CHECK
APPLICANT_.
Lighting Fixtures First 20 .50 ADDRESS
Additional .30
Tocol No.� CITY Jel. No.
Fixed Appliances Not Over l HP PERMIT -
Range_Heater_D.W. _ APPLICANT
� '
Oven_Dryer_W.M.— ADDRESS. yi� ✓"LCL �! C '
Top _FAU — W.H._ CITY Tel,No. _
Hood—Fon _Other_ LICENSEOR
Disp.—Room Air Cond. 2450 REG.NUMBE r Class.
I HEREBY AC O L TH HAVE READ THIS APPLICA
Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO
Size&Type HP, KW, KVA,or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
Yp REGULATING ELECTRICAL WIRING.
Up to 1 Incl. 2'50I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR V
Over 1 to 101nd. 5.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
Over 10 to 50 Ind. 12.50 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF_THE ABOVE
25.00 DESCRIBED RESIDENTIAL PROPERTY.
Over 50 to 100 Inc. PER MI7 EE
Over 100 40.00 BIGNATURE
Services - 12 50 DISTRICT NO.✓ p - PR SED B
0-200 Amp.Under 600 V off
201-1000 Amp. Under 600 V 25.00
Over 1000 Amp.or Over 600 V 50.00 Z
O
Temp. Power Pole&Appurtenances 10.00
Sign with One Branch Circuit 10.00 C
Additional Sign Branch Circuits 2.00 INS7RN
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INFO ",
Misc.Conduits&Conductors 10.00 ONSOther(See CompleteFee Schedulel_
a n650.7A
# 000002
PERMIT FEE (Sub Totoh 2 ° - 2600
Z
PLAN CHECKING FEE (One-Founh Permit Feel O 0 0 0 2 6 0 00'
r
PERMIT ISSUING FEE $7.00 0 9.0 5-7 9
TOTAL FEE off. >
r
INSPECTION FINALED rc
W
7 7 By
date: ' �s
COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
DEPARTMENT OF COUNTY ENGINEER n ^
DIVISION OF BUILDING 6 SAFETY ILIS Il1DUl fill
WILLIAM 1. FOX, COUNTY ENGINEER
'FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO.
ELECTRICIAN /
RECEIVED BY READY FOR DATE ISSUED
ADDRE95 ' Q,I.L'I FIRST INSPECTION
CITY E NO. R '1h ]
COUNTY LICENSE NO. EXPIRE � 'L>D �� BUILDING
PERMIT FEES ADDRESS
FEE
NUMBER EACH LOCALITY
LIGHT OUTLETS NEAREST
RECEPTACLES CROSS
WALL SWITCHES OWNER
TOTAL OUTLETS 5C
MAIL
ELEC. RANGES 25 !O ADDRESS
ELEC. HEATERS 25
49 LCITY TEL. NO.
'
FIXTURES `'-1 L 5
` 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
MISC.
APPLICATION AND STATE THAT THE ABOVE 19 CORRECT
NUMBER OF LIGHT CIRCUITS
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS. REGULATING ELECTRICAL WIRING.
MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
NUMBERHORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
NEW MVO. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
I/]a LHSE $ .25SIGNATURE OF J
Vi 2 .SO PERMITTE l
z 5 1.00 SPECTION RECORD
5 Is 1.50
16 60 2.60 -2 1`I
50 200 5.00 Mr7DP�++�� '
200 Boo 10.00 „J
SOO h0OO 15.00 Q
Z
OVER 1000 20.00 19
M.G. SET/FRED. CHANGER-HP 0
WELDERS: AC-KVA
GENERATORS -KW
TRANSFORMERS-KVA _
TEMP. MOTORS (75% OF ORIG.)
MOVED MOTORS (75% OF ORIG.)
MISC.
SIGNS rt•
NO. NO. TRANS. APPROVALS
NO. NO. LAM
DATE INSPECTOR'S NAME
FOR EACH PERMIT:
WIRING $1.00 Q CONDUIT
FIXTURES $1.00 WIRING
SUPPLEMENTARY .SO FIXTURES
TOTAL FEE $ / TILITY CO, NOTIFIED
1 AL , Lt
76A S63 DOW 6A. 482