HomeMy Public PortalAbout4526 CLOVERLY AVE_Electrical__ 76A653-CEe0e &-59 /�
co�IVTAyPo LIC ANIELES
ON FOR ELECTRICAL PERMIT
DEPARTMEtJT$P COUNTY ENGINEER BUILDING
BUILDING A D SAFETY DIVISION ADDRESS 4526 CIA Y
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY LE Ci Ty
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
NO. EACH F[[ � �
! OWNER W aSW11
RECEIPT._ MAIL SAME TOTAL FIRST 20 .20 ADDRESS
CITY TEL.NO.
SWITCH_ OVER 20 .10 PLAN CHECK
LIGHTING TOTAL I FIRST 20 ,20 APPLICANT
FIXTURES }-1 OVER 20 ,10 ADDRESS
RANGEXDRYER7�WTR. HTR. CITY TEL.N0.
STA. COOK DISP._F.A.U. CONTRACTOR F
SPACE HTR AIR COND. ADDRESS 1U42 S SAN GABRIEa, BLVD,
CLOTFES WASH. DISHWASH. CITYCM GA&UEL TEL.NO.286-1
FAN_OTHER 21 1.00 2 LICENSE N0. 2010.26 CLASS.
MOTORS,TRANSFORMERS RATING I HERE[Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
IND. HEATERS, ETC, HP. KW. KVA. AND STATE THAT THE A[OVE IS CORRECT AND AGREE TO COMPLY
SIZE Q TYPE OVER TO WITH ALL COUNTY bRDINAMCES AND STAT[ LAWS REGULATING
ELECTRICAL WIRING.
0 — 1 1.00 1 HERESY CERTIFY THAT I AM PROPERLY REGISTERED MO/OR
LIC ENSEDAS REQUIRED ■Y LOS ANGELES COUNTY AND •TAT[OF
1 — 10 3.00 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN, TH[ ABOVE DESCRIBED RESIDENTIAL PROPERTY. O
10 - 50 5.00 t V
SIGNATURE W
50 - 100 10D0 OF PERMITTEE Q
100 - 500 5.00 DISTIJCT NO.
7 SIGN,
BED SY
SIGN,GAS SIGN AND ONE CIRCUIT 3.00 i ll-�
TUBE, OR z
MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES: -
SERV ICE NOT OVER 600 VOLTS OR 200 AMP 1 2.00
SERVICE OVER 600 VOLTS OR 200 AMP 5.00
TEMP SERV ICF, POLE, &APP WrEMANCES 3.00 APPROVALS DAT[ MIPECTOWS •IMATURE
TEMP. POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
WIRING
PERMIT FEE (SUB TOTAL) F IXTURES
POWER AUTHORIZED
PLAN CHECK FEE (50% PERMIT FEE)
PERMIT ISSUING FEE 2.00 `l, W
UTILITY CO.NOTIFIED 0 4 t
SUPPLEMENTARY PERMIT ISSUING FEE 1,00 FINAL
JOSEPH C. ROOHAN
TOTAL FEE 6 00
SUPERVISING ELECTRI L ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
2 d 1 4%-D' WN 6 2 D 6.00-
SIE
00NIE ■ACK OF APPLICATION FOR COMPLETE FEE SCHEDULE