HomeMy Public PortalAbout6012 CAMELLIA AVE_Electrical__ 'SA663-CE303 1/70 APPLICATION FOR ELECT-RICA
P IT
` COUNTY OF LOB ANGELEd
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENOIINL[R LOCALITY
COLEMAN W. JIKNKI
JNEAREST
FOR APPLICANT TO FILL IN CROSS ST.
OUTLETS, OWNER
✓I z~�
RECEPT. i MAIL
LIGHT TOTAL
FIRST 20 ADDRESS
CITY r TEL. N0. -3
SWITCH OVER 20 .10 PLAN CHECK
LIbHT1N0 TOTAL FIRST 20 y APPLICANT
OVER 20 ADDRESS
FIXTURES .10
APPLIANCES CITY TEL. N0,
PERMIT
RANGE DRYER_,_WTR. HTR. APPLICANT
STA. COOK DISP. . F.A.U. ADDRESS
SPACE HTR.-AIR COND. CITY TEL. N0.
CLOTHES WASH. DISHWASH, LICENSE NO. CLASS.
FAN OTHER 100 I HERESY ACKNOW-LEDGE THAT I HAVE READ THIS APPLICATION
AND /TAT[ THAT TH[ ABOVE 18 CORRECT AND A/R[[ TO COMPLY
MOTORS TRAIT/FORM[RS RATINS WITH ALL COUNTY ORDINANCE! AND /TAT[ LAW! REGULATING
IND. HkAT[R/, [TC. HP. KW. KVA. IT WIRING.
SIZE TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY R[GI/T[R[D AND/DR
0 — 1 1.00 LICENSED AS REOU IRED /Y LOS ANGELES COUNTY AND STAT[ OF
CALIFORNIA OR THAT I AM THE LEGAA
L OWNER F, AND INTEND TO
1 1G 3A0 RESIDE IX, THE A/0 DESCRIS[D RKSID[NIIA` FROPERTY,
SIGNATURE
10 - EO e00 OF PERMITTE
60 — IDG 1 DI/ 11IX0 O
100 - b00 15.00
As$ z;f!-,3
SIGH, GAS SIGN AND ONE CIRCUIT 300 NOTES:
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.001
3ERVICENOTOVERBOOVOLTS OR200AMP i00
APPRQVAL/ DAT[ VCM-[CTOWS SXWMTUR11
SERVICE OVER800 VOLTS OR 200 AMP b00
TEMP.POWER POLE
TEMP SERVICE,POLE, &APPURTENANCES 3.00
UNDERSLAB WORK
TEMP LIGHT OR RECEPT. SYSTEM 3.00
ROUGH CONDI UT
WIRING
FIXTURES
PERMIT FEE (SUB TOTAL)
POWER AUTHORIZED
PLAN CHECK FEE(50% PERMIT FEE)
UTILITY CO. NOTIFIED
PERMIT ISSUING FEE n
FINAL a �
SUPPLEMENTARY PERMIT ISSUING FEE ID0
JOSIEPILI C. ROO
TOTAL FEE SUPERVISING EL7cK2j
L ENGINEER
PLAt1CH(=GKVALIDATION CK. M.O. CASH PERMIT VALIDATION . M.O. CASH
AP- 1 3 9 6F' Jif 13 2 D $,�? 0'' v
![E SACK OF APPLICATION FOR COMPLETE SCHEDULE `�`�
76A66:I-wE806 B-62 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER rE'UILDING/BUILDING AND SAFETY DIVISION DDRESS �JOHN A. LAMBIE, COUNTY ENGINEERWILLIAM A. JENSEN, SUPT OF BUILDING OCALITY ��/
NEAREST
FOR APPLICANT TO FILL IN I CROSS ST. 'cam"
RECEPT. TOTALNO. EACH FEE
OUTLETS FIRsr 20 $20 $ OWNER ( 7 >r�/✓
LIGHT MAIL -
ADD'L .1O
SWITCH. OVER 20 ^�
J c'
LIGHTING TOTAL FIRST 20 ,20 CITY 7 't_= s TEL. NO. s'>`'
FIXTURES I ADD'L iC ELECTRICIAN �A/A/r,,'
OV R 20
RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS
GARB,DISP. STA.COOK
CITY _ TEL. NO.
DISHWASH. AUTO.-WASH. STATE
SPACE HTRS. STA.APP.(/a H.P.MAX.) ,50 LICENSE NO.
MOTORS: OVER NOT OVER H.P. DISTRIC N T Z E
O 1 1.00
1 s 1.50 INS/PECTION RECORD
s 8 2.00
8 15 2.50 � J
15 50 8.00
a.
50 100 5.00 t / 0
7 (� L-
SIGNS, NO.TRANS-
NO.LAMPS
SERVICE O-SOOV-NOT OVER 200A 1.00
a
SERVICE 0.60OV-OVER 200 A. 2.00 Z
SERVICE OVER SOOV 5.00 �� �� ' df 1►y —
L'
MISC.
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE $
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'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 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. t POWER
SIGNATURE ` UTILITY CO.NOTIFIED
OF PERMITT E
FINAL
VALIDATIARTHUR C. VEIT
CK MO ,GASH SUPERVISING ELECTRICAL ENGINEER
�,� 2 5 7 2"'o" IUi*R _ D 3.00-