HomeMy Public PortalAbout4858 CLOVERLY AVE_Electrical__ 7SA663 SA 25M SETS 7-48 P C TION FOR
P
ERNU
$DEPART'ldlEI�r OF BUILDING AND SAF1E'I'S tl= LIIrLil ill Yi ELECTRIC
COUN'T'Y OF LOS ANGELES
M F C 1 E GI E R
NAME✓ DISTRICT NO. GROUP ZONE PERMIT NO.
U ADDRESS oL"- ' ��t7 d r7
CITY ' TEL O RECEIVED BY READY FOR DATE ISSUED
COON FIRST INSPECTION
LICENSE NO EXPIRES 3
APPLICANT' FILL. IN HEAVELY OU'T'LINED PORTION ONLY
JOB
IDESCREMON OF WORD A DRESS /O 0
NUMBER OF OUTLETS ON CIRCUITS LOCALITY �1
LOCATION BY ROOMS
NEARESLIGHT OUTLETS SW PLUGS FIXT CROSS Zr--S
CIRCUIT A ,B C 1 D 1 E F IG JH I Cc NAME
/, C - WMAIL
ly��
t/j ? l 1 � , 3 ADDRESS I19®Q r10 �" � 1�Y7 �IY 6.,✓
O CITY �ntYi CeR� TEL O x1 7/o7P/,d
AM THE LE AL POSSESSOR OF THE ABOVE LAS
ANBL*,I.ES COUNTY CERTIFICATE OF QUALIFICATION.
2 ELECTRICIAN
ry r I AM THM LEGAL OWNER OF PROPERTY DESCRIB
�q ABOVE
OWNER
CORIi MONS
J
Q
Z_
O
TOTAL
/
No OF OUTLETS APPROVALS
NO OF FIXTURES $ 7 DATE INSPECTQR'S NAME
NO OF MOTORS H P $ CONDUIT
NO OF SIGNS TRANS $ WIRING
NO OF RANGES OR HEATERS $ FIXTURES /f
MISCELLANEOUS $ POWER
PERMIT FEE UTILITY CO NOTIFIED
TOTAL FEE FINAL
76A663 CE806 4 65 APPLICATION FOR ELECTRICA�P MIT {�
O LI
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER FNEAREST
G fD��
BUILDING AND SAFETY DIVISION /
JOHN A LAMBIE, COUNTY ENGINEER
COLEMAN-W JENKINS SUPT OF BUILDINGY ! f�
FOR APPLICANT TO FILL IN T
RECEPTACL TOTAL NO I EACH FEE
tJ
LIGHT C? OUTLETS FIRST 20 O $ 20 OWNER$ 7 MAIL
SWITCH OVADD ER L 10 I ftf ADDRESS
TOTAL FIRST 20 20 O CITY TEL NO
LIGHTING 1 FIXTURES
FIXTURES )r ADD L 10 CONTRACTOR �ed� /G
OVER 20
RANGES CLO DRYERS WTR HTRS 1 OO ADDRESS
GARB DI3P STA COOK ;OZ/s
CITY �r✓ �i.� TEL NO �� f
DISHWASH AUTO WASH STATE q Q
SPACE HTRS STA APP (+/y H P MAX ) 50 LICENSE NO rC �J_,
MOTORS OVER NOT OVER H P DISTRICT NO _FVPI ZONE SED
O 1 100 rd
1 3 15o INSPECTION RECORD
3 8 200
B Is 250 }
15 50 300 O
V
50 100 500
cc
SIGNS NO TRANS 10
NO LAMPS f 1
SERVICE O 600V NOT OVER 200A 100 N
SERVICE O 600V OVER 200 A 200
SERVICE OVER 600V 500
OTHER (SEE COMPLETE FEE SCHEDULE)
PERMIT ISSUING FEE 200
SUPPLEMENTAIRY PERMIT ISSUING FEE 11001
TOTAL FEE 0O APPROVALS DATE INSPECTOR S SIGNATURE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION UNDERSLAB WORK
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ROUGH CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING /
ELECTRICAL WIRING WIRING
1 HEREBY CERTIFY THAT AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND INTEND TO POWER i
RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY
SIGNATURE UTILITY CO NOTIFIED
OF PERMITTEE
FINAL
(fKMO CA JOSEPH C ROOHA
tf
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
Ao 1 1 3 5 APR 11 2 D 8.8 O N
� I