HomeMy Public PortalAbout9957 BROADWAY_Electrical__ APPLICATION FOR ELECTRIC PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION gODRE55 7 77 //
JOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY
MMMM
FOR APPLICANT TO FILL IN NEAREST
PERMIT FEES CROSS ST. Ar
/
ITEM NUMBERI EACH FEE OWNER Y
MAIL
OUTLET$: - ! S 5
LIGHTS 7^ RECEPI'. SW. 11 .10 ADDRESS
LIGHTING FIXTURES f0 ��� CITY TEL.NO.
ELEC.RANGES CLO.ORYER3 ELECTRICIA
WATER HEATERS .50 ADDRESS
ELEC.SPACE HTRS. DISHWASHERS
CITY TEL. NO.
GARBAGE DISPOSERS AUTO.
STATE
WASHERS BTA.COOKING UNITS .25 LICENSE NO.
MOTORS: OVER INC. H.P. DISTRICT NO. G UP ZONE PROCESS DBY
O— 1/z .25 /
l/— 2 .50 INSPECTION RECORD
2— 5 1.00
5— 15 1.50
15— 50 2.50 ✓ �y
50-200 5.00
NO.TRANS. 9
SIGNS:
NO.LAMPS
SERVICE 0-600V 1.00 $'. 7-7 40
SERVICE OVER 600V 5.00
MISC.
Slffd vAM
WIRING PERMIT 1.00 1V11 . �7tr-ff*f5�'T.1 Afo%(fl
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT .50
TOTAL FEE 8
1HEREBY ACKNOWLEDGE THAT I HAVE REAO THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATINO CONDUIT
ELECTRICAL WIRING. WIRING ;1 7-
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
CALIFORNLICENSEDIA SORREQUIRED
THAT OBY I AMLOS ANGELES THE LEGAL OWNER FTHE ABOVE ND STATE OF FIXTURES
DESCRIBED RESIDERL PROPERTY. ' POWER
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITTEE FINAL �'"22—e0 IYs1ILl�JD
®r VALIDATION, ARTHURV
CK MO CASH { SUPERVISING ETT,
GIT,ELECTRICAL ENGINEER
LLDo 6 3 42� Nly 11 2 A 2 .7 0
76A663 CE-SA F6/76 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
,U
FOR APPLICANT TO FILL IN JOB Ale
New Residential Bldgs.&Pools EACH NO. FEE ADDRESS
1 &2-Family,Sq.FL $r — $ LOCALITY
Multi-family Sq.Ft. — NEAREST
ROSS ST,
Residential Swimming Pools OWNER OR
''//,, FIRM NAME
Outlets: Reccelight Sw.2 MAIL -
� ((��' First 20 —' ADDRESS
Total No.._(.— Additional CITY a - Tel. No.
PLAN CHECW
APPLICANT
Lighting Fixtures First 20 ADDRESS./
Total No. Additional CITY Tel.No.
Fixed Appliances Not Over I HP PERMIT
Range_Heater_ D.W._ APPLICANT, �
Oven—Dryer_ W.M.— ADDRESS ✓l
Top _FAD W.H. — CITY f�,�„� ! Tel.No.
Hood—Fan Other_ LICENSE OR
Disp._Room Air Cond. ` REG.NUMBE Closs.
I HEREBY ACKNOWLEDGE THAT I 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
REGULATING ELECTRICAL WIRING. y
Up to I-Incl. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR O
Over 1 to 10 Incl. LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF V
Over 101a SO Ind. CALIFORNIA OR THAT I AM THE LEGAL OWWNENNEEERR✓///FOFF/T/}�E ABOVE
DESCRIBED RESIDENTIAL PR ERT%<J�/f`'L- "'"
Over 50 to 100 Inc.
PERMIT
Over 100
SIGNATURE N
Services 77vDISTRICT NO. P ES D BY g
0-200 Amp.Under 600 V i /�- U �J o
201-1000 Amp. Under 600 V c� �'
Over 1000 Amp.or Over 600 V Z
O
Temp, Power Pole&Appurtenances Q
Sign with One Branch Circuit j
Additional Sign Branch Circuits INSPECTION >
INFORMATION 6
Misc.Conduits&Conductors ON REVERSE S
Other(See Complete Fee Schedule)_ SIDE u
Z
5 ;95058A
#.O 0'0.0 O 2
PERMIT FEE ISu6 Total)
Z 2 - 3500
PLAN CHECKING FEE IOne-Fourth Permit Feel O
,O OO V
PERMIT ISSUING FEE o 3 O 0=
a 0621 -79
TOTAL FEE >
INSPECTIOI 7//YFWALED W
dote: 72/79 BY/ 6 ts
76,?553-CEbi510/72 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER nooREss
BUILDING AND SAFETY DIVISION
LOCALITY
NEAREST KLbW/)t/
FOR APPLICANT TO FILL IN CROSS ST.
OUTLETS NO. EACH FEE OWNER 09
RM NAME
RECEPT._ 5 5
MAIL
LJGFIRST 20 25 ADDRESS
SWITOTAL SWITCH_ OVER 20
CITY TEL. N�
10 PLAN CHECK
LIGHTING FIRST 20 25 APPLICANT
FXTURES TOTAL .10
OVER 20 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL. NO.
PERMIT
RANGE_ORYERWTR. HTR._ APPLICANT
STA. COOKDISP. F.A.U. ADDRESS
SPACE HTR. AIR GOND. CITY TEL. NO.
CLOTHES WASH. DISHWASH.� LICENSE OR CLASS.
REG. NUMSER
FAN_OTHER 1 1,00 I NENE BY ACRND'NLEDGE THAT I HAVE READ THIS APPLICATION
ANO STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND. HEATERS, ETC. HP. KIN KVA. ELECTRICAL WIRING.
S ITE B TYPE OVER TO
HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 - 1 100 CALIFOE0 AS RETHAIED BY LOS PNGELES COUNTY AND STATE OF
CALIFORNIA OR THAI AM THE LEGAL OWNER OF THE ABOVE T
1 - 10 300 DESCFIM1ED RESIDE NiIAL PROPERTY.
OPERT T. CL
PERMITEE U ••� U
10 - 50 5.00 SIGNATURE
O
50 - 100 10.00 DISTRICT NO. / CESSED BY W
500 - 500 15.00 v QU / d
GO,
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTOR'S SIGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 100 TEMP. POWER POLE
SERVI CENOT OVER 600 VOLTS OR 200 AMP 30 UNDERSLAB WORK
SERVI CE OVER 600 VOLTS OR 200AMP 10.00 ROUGH CONDUIT
TEMPSERVICE, POLE, &APPURTENANCES 5.00 WIRING
TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES
POWER AUTHORIZED
UTI LI TV CO. NOTIFIED / l
FINAL Gd�,30 7S �� �.stlsS�
PERMIT FEE (SUB TOTAL) NOTES:
PLAN CHECK FEE
PERMIT ISSUING FEE 3.00
TOTAL FEE gfR;^ %667 dd ,
PLAN CHECK VALIDATION CK. M-0, CASH PERMIT VALIDATION crc. M.O. CASH
y 4 iivii jU 2 U •,�}� 4.0 0 iuyb
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE V /I