HomeMy Public PortalAbout9529 BROADWAY_Electrical__ 78A653-CE806 I/70 APPLICATION FOR ELEC ICA L ftkknr u
COUNTY OF LOS ANGELES
•DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
I• COLEMAN W. JENKI NS SUPERINTENDENT OP BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST. -CYVI �� 1 P
OUTLETS N0. EACH FEE OWNER t] C
RECEPT. $ $ MAIL �C � K(3cxC Lam_`
FIRST 20 ADDRESS / It
LIGHT_ TOTAL S CITY tvVY/V Q1,,,�, EL. NO. 5 6Y
SWITCH_ 1 OVER 20 10 PLANCHECK
TOTAL
LIGHTING FIRST 20 20 -APPLICANT
FTURES OVER.20 .ID ADDRESS
IX
APPLIANCES - CITY r�^T TEL. N0,
PERMIT
RANGE_DRYER_WTR. HTR,_ APPLICANT! V LlI wo `C'Z.1
STA. COOKDISP._F.A.U._ �
ADDRESS �( d H. Q\W `/
SPACE HTR, AIR COND. CITY ��C✓K.. L' 1.1 TEL'. NO. p S 5-G
CLOTHES WASH. DISHWASH._ LICENSE NO. 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
MOTOR9, TRANSFORMERS RATING WIT, ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND. ,EATERS, ETC. HP. KW. KVA. ELE CTq ICAL WIRING.
SIZE & TYPE OVER TO
HEREBYCERTIFY THAT AM PROPERLY REGISTERED ANO/OR
0 - 1 100 LICENSED A9 EO BY LOS ANGELES COUNTY AND STATE OF
I
CALIFORNA CRY
THAT TNAT I AM THE LEGAL OWNER OF, AND INTEND TO
1 - 10 300 RESIDE N, THE ABOVE DESCRIBED RES�ID/E/f;TIAL PROPERTY.
SIGNATURE r'�.1^-SIL i&LQD a
10 - 50 5.� OF PERMITTEE FI RG a �J (il.le�
50 - 100 1000 DISTRICT NO. CLASSGROUP Z -F irO SS ED BY O
100 - 500 15,00 -5. 09 -:;� V
SIGN, GASW
SIGN AND ONE CIRCUIT 3.00 NOTES: N
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 100 ?
SERVICENOT OVER 600 VOLTS OR 200 AMP 2.00
.APPROVALS DATE INSPECTOWS SIGNATURE
SERVICEOVER600VOLTSOR200AMP 500
TEMP.POWER POLE
TEMPSERVICE,POLE, &APPURTENANCES 3.00
UNDERSLAB WORK
TEMP LIGHT OR.RECEPT.'SYSTEM 3.00
ROUGH CONDIUT
WIRING
PERMIT FEE (SUB TOTAL) FIXTURES
POWER AUTHORIZED
PLAN CHECK FEE (50% PERMIT FEE)
UTILITY CO. NOTIFIED
PERMIT ISSUING FEE 2.00 U ��
FINAL 7
SUPPLEMENTARY PERMIT ISSUING FEE 100 D ,
_ ' JOS PH C. ROOHAN
TOTAL FEE SUPERVISING ELECTRICAL ENGINEER.
PLAN CHECK VALIDATION CK. M.G. CASH PERMIT VALIDATION CK. M. CASH
° 21 ,5,5�, AU8- (� 2 D
�_i�o 3 4 2 5
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE - _