HomeMy Public PortalAbout5020 CAMELLIA AVE_Electrical__ DBEPARTMENP OF BUILDING AND SAFE
APPLIC4'ITION FOR PERIM
COUNTY OF LOS ANGELES v LEClTR.IC
M. J. FOX CHIEF ENGINEER
NAME DISTRICT NO. GROUP ZONE PERMIT NO.
U ADDRE$8 Z.
L
CITY F TEL NO. ( RECEIVED BY READY FOR DATE ISSUED
ILI FIRST INSPECTION
COUNTY /
CERT.N0. ��f? EXPIRES
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
JOB
DESCRIPTION OF WORK ADDRESS G .—I✓
NUMBER OF OUTLETS ON CIRCUITS LOCALITY
LOCATION BY ROOMS
NEAREST R
LIGHT OUTLETS SW. PLUGS F17CT CROSS ST.
CIRCUITA B C D E F G H W NAME
/ / Z MAIL
( ADDRESS
Z o
CITY TEL.NO.
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS
/ ANGELES COUNTY CERTIF ATE F - UALIFICAT►ON..
/ ELECTRICIAN.
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
/I ABOVE
OWNER.
l/ CORRECTIONS
J
Q
Z_
I7
R
D
TOTAL (J
NO. OF OUTLETS ji `. - $ ZS APPROVALS
NO. OF FIXTURES $ DATE INSPECTOR'S NAME
NO. OF MOTORS H.P. $ CONDUIT
/ F
NO. OF SIGNS TRANS. $ WIRING
NO. OF RANGES OR HEATERS $ FIXTURES
MISCELLANEOUS $ c POWER
PERMIT FEE $ 1J UTILITY CO.NOTIFIED
TOTAL FEE C FINAL
r
76A663-CE806 3-64 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS .
JOHN A. LAMBIE, COUNTY ENGINEER /
WILLIAM A.JENSEN, SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
RECEPT. TOTALNO. EACH FEE -
OUTLETS FIRST 20 ffi 2O E OWNER
LIGHT
LIGHT r/ MAIL
x ADWL ADDRESS r►1f, �kC,
SWITCH. - V OVER 20 .10
LIGHTING
CITY 'p'J ./� TEL. NO. G O
rTOTALFIRST 20 .20FIXTURES ADD'L 1O ELECTRICIAN
OVFR 20ON
RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS
GARB.DISP. STA,COOK CITY TEL.NO.
DISHWASH. AUTO.-WASH. STATE
SPACE HTRS. STA.APP.(v,N.P.MAX.) .50 LICENSE NO.
MOTORS, OVER NOT OVER H.P. DISTRICT NO. GROUP ZNE CESSED BY
O 1 1.00 dQ
I s 1.50 INSPECTION RECORD
a
9 5 2.00 O
U
B 15 2.50 Dc
1a 50 9.00 0
I-)
50 too 5.00 d
V)
SIGNS, NO.TRANS Z
NO.LAMPS
SERVICE 0.500V-NOT OVER 200A 1.00
SERVICE O-SOOV-OVER 200 A. 2.00
SERVICE OVER GOOV 5.00
MISC.
PERMIT ISSUING FEE 2.00 Q
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE i
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS GATE INBPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM T E LEGA�DWNEZRF THE ABOVE
DESCRIBED REBIDENTIA OP Y. POWER
SIGNATURE ? UTILITY CO.NOTIFIED
OF PERMITTEE
FINAL -
VAL (� ARTHUR C. VETT
h( CASH,, CASH SUPERVISING ELECTRICAL ENGINEER
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