HomeMy Public PortalAbout9711 BROADWAY_Electrical__ 76A663 CE 906R 10/]] APPLICATION FOR ELECTRICAL PERMIT
Y LJ
r COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER JOB
BUILDING AND SAFETY DIVISION ADDRESS
FOR APPLICANT TO FILL IN LOCALITY �T v
New Residential Bldgs.&Pools EACH NO. FEE NEAREST
I &2 Fomily,Sq. Ft. $ .025 — $ CROSS ST. /L.• (.( ����
OWNEROR
Multifamily Sq. Ft. .02 — FIRM NAME eg LR9 'C dJ
Residential Swimming Pools 25.00 MAIL i7�f� nfCC
ADDRESS .0 01' / "
Outlets:Ren Light !C-- CITYTel.No,
First 20 .50 `; OO PLAN CHECK
Total No.—(:;�: _ Additional .30 APPLICANT
ADDRESS
Lighting Fixtures First 20 .50 1j p(z CITY Tel. No.
Additional .30 PERMIT
Total No. APPLICANT -C7 uCI- 7d Xelo
Fixed Appliances Not Ovq�Jh�,'!I<&- ADDRESS �Q' ' �� _�p ux6,)e y
Range—Heaterl—T. CITY ' .yyC `P L1Tel.
Oven _Dryer_W.M. LICENSE OR ��//
Top —FAU —W.H. Ls-REG. NUMBER _ Class. Q
Hood_Fan _Other_ ) )� HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
Disc. _ Room Air Cord. 2'50 K ✓ THA!THE ABOVE IS CORRECT AND AGREE TOCOMPLY WITH ALL COUNTY GROIN-
. ANCES AND STATE LAWS REGULATING ELECTRICAL WIRING.
Power Apparatus&Large Appliances
Size&Type HP, KW, KVA,or KVAR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED PND/OR LICENSED AS
2.5D REQUIRED BY LOS ANGELE UNTY AND STATE OF CALIFORNIA OR THAT I AM d
Up to 1 Incl. THELEGALOwNER OF T AB OV E DESCRJJJeee���D RE9DENTI PR ERTY. 0
Over 1 to IO Incl. 5.00 s
Over 10 to SO Inc. 12.50 PERMITTEES Z
ERMIT!EESIGNATURE
25.00
Over 50 to 100 Inc. v
Over 100 40.00 DISTRICT NO. PROC SEDaBY / h
Services
S � 3 �af.L1y � z
O 0 200 Amp. Under 600 V 12.50 / Z M APPROVALS DATE INSPECOOE
SIGNATURE01-1000 Amp.Under 600 V 25.00
Over 1000 Amp.or Over 600 V 50.00 TEMP. POWER POLE
UNDERSLAB WORK
Temp, Power Pole&Appurtenances
10.00
Sign with One Branch Circuit 10.00 ROUGH CONDUIT
Additional Sign Branch Circuits 2.00 WIRING
Mac.Conduits&Conductors 10.00 FIXTURES _
Other(See Complete Fee Schedule! POWER AUTHORIZED
UTILITY C_O. NOTIFIED _
FINAL
PERMIT FEE (Sub Totals NOTES �(j I�1/�,Q/,t/�y O/< A) /I-pp lTrow
I PLAN CHECKING FEE (One Fourth Permit Feel ? � C T Go22 0,t)A5vr'e'9--L QIL5,,,
PERMIT ISSUING FEE $7.00fTOTALFEE N J •��'
CASH PERMIT VALIDATION CK'. M.O. CASH
a
nOO��LIIC±}Y HOLDER; c e
�` U(B CTYi7tP[stir 11a ION FOR COMPLETE SCHEDULE.��': 5 '' pa� '2 2 5 G OJv
t-
t,.• COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
DEPARTMENT OF COUNTY DIVISIONSSAENGINEER
•
DIVISION OF BUILDING � SAFETY Ill\)1
WILLIAM 1. FOR, COUNTY ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUPZONE PERMIT NO. �
ELECTRICIAN /Pe s)1.La �/ /7 7�3/
ADDRESS h ' RECEIVED BY READY FOR DATE ISSUED
v FIRST INSPECTION
CITY '1/G�� TEL. NO � �jFFF1LLLli�v/I
COUNTY LICENSE NO I . �� EXPIRES BUILDING 7
PERM-FEES ADDRESS / t
FEE
NUMBER EACH LOCALITY
LIGHT OUTLETS NEAREST
RECEPTACLES CROSS ST ,
WALL SWITCHES OWNER
TOTAL OUTLETS 5c $ MAIL
ELEC. RANGES 25 ADDRESS /
TEL. N
ELEC. HEATERS 23 II/''•v J
FIXTURES B o CITY
4
MISC. I HER/q Y ACKNOW D E THAT 1 AVE READ THIS
NUMBER OF LIGHT CIRCUITS I Q APPLICAT N AND STA THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING.
MOTORS I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
Num eeRHORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
New MVa. HP oVRR INC. HAGN OF THE RE9IDENTI L PROPERTY DESCRIBED ABOVE.
I/v a Less $ .23
SIGNATURE OF
Vs 2 .50 PERMITTE
2 5 1.00 INSPECTION RECORD
5 15 1.so
15 50 2050
50 200 5.00
200 500 10.00 -�
500 1000 13.00 Q
Z
OVER IOOO 20.00 I�
M.G. SBi/FRHO. CHANGER-HP R'
WELDERS: AC-KVA O
GENERATORS -KW
TRANSFORMERS-KVA
TEMP. MOTORS (75 OF GRIG.) _
MOVED MOTORS (7S% OF ORIG.)
MISC. I
SIGNS
NO. NO. TRANS. APPROVALS
NO. NO. LAMPS
FOR EACH PERMIT: DATE INSPECTOR'S NAME
WIRING $1.00 Q CONDUIT
FIXTURES $1.00 WIRING
SUPPLEMENTARY .SO FIXTURES
POWER
TOTAL FEE $3 �D UTILITY CO, NOTIFIED —
FINAL
76A 6sa Gas# BA. 4-6e