HomeMy Public PortalAbout9814 BROADWAY_Electrical__ 76g663-CEB06 10/72 APPLICATI®N"'F®R, E*TRIC AL PER*i x�
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER Joe
oRE65
BUILDING AND SAFETY DIVISION
LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST. _
OUTLETS * NO. EACH EEE. OWNER OR
RM NAME
RECEPT._ $ S MAIL
1 FIRST 20 ADDRESS
LIGHT TOTAL .25
CITY TEL.
SWITCH OVER 20 10 '
PLAN CHECK '
LIGHTING TOTAL FIRST 20 25 APPLICANT
FIXTURES .10
OVER 20 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL. NO.
PERMIT
RANGEDRYEP_WTR. HTR._ APPLICANT
STA. COOK_OISP. F.A.U._ - ADDRESS
SPACE HTR. AIR COND. CIT TEL. NO.y�' 2_,
CLOTHES WASH. DISHWASH._ REGENSE UMBER �. CLAS -��
FAN_OTHER 100 1 VERY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
ANO STATE THATTHE ABOVE IS CORRECT AND AGREE TO,COMPLY
MOTORS. TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND. NEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING.
. SIZE &TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
i 0 - 1 1.00 (� LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER JIF THE ABOVE Y
DD DE$CRRED RESIDE TIAL ROPERTY. d
• lY- Y IO
PERMITEE - / _ V
_ �`• („� 10 - 50 .00 SIGNATURE c Ca
CD
50 - 100 1000 (-
DISTRICT NO. ^� PROC SED BY W
100 - 500 15.00 i7 �.
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS !� DATE INSPECTO ' SIGNATIJRE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 100 TEMP. POWER POLE
SERVICENOTOVER 600VOLTSOR200AMP 300 UNDERSLAS WORK
SER'JICEOVER 600 VOLTS OR 200 AMP 10.00 ROUGH CONDUIT '
TEMPSERVICE,POLE, &APPURTENANCES 5.00 WIRING
TEIJP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES 1
_ I
POWER AUTHORIZED • 1 -
UTILITY CO. NOTIFIED '
_ FINAL _� .. M
PERMIT FEE (SUB TOTAL) NOTES:
PLAN CHECK FEE
PERMIT ISSUING FEE 3.000Q•&
TOTAL FEE
PLAN CHECK VALIDATION CK. M.O: CASH PERMIT VALIDATION cn. M.D. CASH
0 7 3�JUN 27 2 1 1 o Q A:;8
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
76A663 CE606 468 APPLICATION FOR EL ECTRBCA PERMIT
COUNTY OF LOS ANGELES
-DEPARTMENT OF COUNTY ENGINEER �/ Ld J D A
BUILDING AND SAFETY DIVISION BUILDING
�7 Y !/O�Q�!✓ i,7
JOHN A. LAMBIE. COUNTY ENGINEER p p� v 1'
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING
NEAREST
FOR APPLICANT TO FILL IN ��� C� (I
CROSS ST. �j• b�
NO. EACH
FEE Ay
RECEPT. $ S OWNER G t '/�ts, w� }� �®®
MAIL 410V AGI I/�Q �07
LIGHT TOTAL FIRST 20 .20 ADDRESS
SWITCH OVER 20 .10 CITY A V TEL. NO.
./� PLAN CHECK
LIGHTING lTOTAL FIRST 20 .20 o APPLICANT
FIXTURES 1! OVER 20 .10 ADDRESS
RANGE_DRYER.�WTR.HTR,_ (CITY TEL. NO.
STA.COOK_DISP. F.A.U.— CONTRACI-OR
SPACE HTR.J—� AIR GOND._ ADDRESS
CLOTHES WASH._OISHWASH._ CITY TEL. NO.
FANLOTHER �
LICENSE IND. CLASS.
MOTORS,TRANSFORMERS RATING
IN HEATERS, ETC. HP. KW. KVA. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE & TYPE OVER TO AND STATE THAT TME ABOVE IS CORRECT AND AGREE TO COMPLY
WITN ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
0 - 1 1.00
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
1 - 10 3.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF Y
ULIFDq NIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
10 - 50 S.00 RESIDE IN, THE ABOVE DESCRIPED RESIDENTIAL PROPERTY. p
U
50 - 1001000 SIGNATURE /� a
OF PERMITTEE A p
100 - 500 15.00 w
DIST GRQSIP20 N.E CESBY
ff
SIGN,GA$ SIGN ANO ONE CIRCUIT 3.00 A
TUBE, OR
Z_
MAROUEE AUDI TIONAL ITS 1.00
NOTES:
SERVICE NOT OVER 600 VOLTS OR 200 AMP 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
If
WIRING
PERMIT FEE (SUB TOTAL)
FIXTURES �� _ 6
PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED 1
PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED y,
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL "I // •h/t�
TOTAL FEE JOSEPH C.IROOHAN
SUPERVISING ELEC CAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
l_IAP, 9 3 1 0 APR 11 2 D 6.4 0/�I r/
IEE RACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
)6A663C- CEe663.12/]5 APPLICATION FOR ELECTRICAL PERMIT -
• SUILD�SAFET DIVISION
'FOR APPLICANT TO FILL IN
New
�
New Residential Bldgs. & Pools
EACH NO. FEE ADDRESS9 14 13 y`o^t'C7 wA4
1 &2 Finaily Sq. Ft. S — S T LO CALITv Q I C'
Multi-family Sq. Ft. NFARESI CFOSS ST. - .el W`' "
Residential Swimming Pools OWNER OR
FIRM NAME /F
Outlets: Light,Switch& Receptacle MAI L
First 20 Q ADDRESS 96tI4_ 6' wiq.<1
Additibnal CITY eM 1� L.4:! Tel. No.
PLAN CHECK
Lighting Fixtures 1 APPLICANT
First 20 ADDRESS
Additional
CITY Tel. No.
PE R Fixed Appliances Not Over 1 HP APP LII(CANTgdlq �LEC�"1'I�LC
Range Heater D.W. ADDRESS
Oven Dryer W.M.
Top FAU W.H. CITY Cillli T.I. No. 14'15-756
Hood Fan If LICENSE OR / b
REG. NUMBER "Z ' a78"� Class. G'-- ( O
Disp. A.C. 50
s
Power Apparatus& Large Appliances RDINANCES AND STATE Laws REGULATIN
AGO STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
Size&Type HP, KW, KVA,or KVAR ELECTRICAL WIRING. w
Up tot Incl. �ERTIEYTHAIA. No/oR h
Over 1 to 10 Incl. Z
.1IE.RN.A OR THAT . A. THE LEGAL OWNER AP THE II.SC
Over 10 to 50 Incl RESio 0
Over 50 to 100 Incl. PERMITEE
Over 100 SIGNATURE
Services DISTRICT NO. RO ESSE BY
0-200 Amp. Under 600V ,VIp ,
201 - 1000 Amp. Under 600 V APPROVALS DATE - NSPECTOR'S
Over 1000 Amp.or Over 600 V ,
SIGNATURE
TEMP. POWER POLE -Temp. Power Pole&Appurtenances UNDERSLAB WORK
Sign with One Branch Circuit
Additional Sign Branch Circuits ROUGH CONDUIT w
(Other) WIRING y-Z7-77
FIXTURES
POWER AUTHORIZED
PERMIT FEE (Sub-Total) UTI LITV CO.NOTIFIED
PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL
PERMIT ISSUING FEE NOTES
TOTALFEE
( PLAN CHECK VALIDATION CK. M.O. CASIJ PERMIT VALIDATION _CK. M.O. CASH
I , —
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