HomeMy Public PortalAbout4921 CLOVERLY AVE_Electrical__ •+��� 1) �
DaS 5A t2 54 APPLICATION FOR ELECTRIC PERMIT ],
DBS SA
DIVISION OF BUILDING AND SAFETY
Department of County Engmeer
County of Los Angeles BUILDING
WM J FOX COUNTY ENGINEER JADDRESS
CASSATT D GRIFFIN SUP T OF BUILDING r
FOR APPLICANT TO FILL IN LOCALITY _
PERMIT FEES NEAREST
FEE CROSS ST
'
NUMBER EACH
LIGHT OUTLETS OWNER
., —9—
RECEPTACLES MAILADDRES
WALL SWITCHES �}
TOTAL OUTLETS 54 S �a CITY EL NO o—
ELEC RANGES 25 ELECTRICIAN
ELEC HEATERS 25 ADDRESS 4L/6�IcI'�
KW EA CITY TEL NO
FIXTURES 5 �� LICENSE NO
NUMBER OF LIGHT CIRCUITS
DISTRICT NO JGROUP MZE, I READY FOR INSPECTION
NUMBER OF RECEPTACLE CIRCUITS ij
MOTORS
NUMBER HORSEPOWER FEE INSPECTION RECORD
NEW MVD HP OVER INC EACH
_ I�&LESS $ 25 '
1/Z 2 50
2 5 1 00
5 15 1 50
is 50 2 50
50 200 500
MISC
I
NO SIGNS NO TRANS )
NO SIGNS NO LAMPS
FOR EACH PERMIT
WIRING $100
FIXTURES $100
SUPPLEMENTARY 50
APPROVALS
TOTAL FEE $ /�/ DATE INSPECTOR SSIGNATURE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CONDUITAND p
STATE ALL COUNTY ORDINANCESE ABOVE IS AND CORRECT
LAWS TO COMPLY
WITHREGULATING WIRING - ;'K �Iuts
ELECTRICAL WIRING L
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF POWER
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTI POPERTY .^
�\�!v!^ UTILITY CO NOTIFIED �C� t
SIGNATURE yV 1L a
OF PERMITTEE FINAL
WILLIAM J FOX, COUNTY ENGINEER VALIDATION2 5 (� M
XY 9 "' PLAY 31 2
–V DEPUTY
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