HomeMy Public PortalAbout5702 CLOVERLY AVE_Electrical__ 74663-CEB11R ,, APPLICATION FOR ELECTRICAL PERMIT
• COUNTY OF.LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS-
COLEMAN
DDRESS J�7G Z �G vel/
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS, SUPERINTENDENT OF-BUILDING LOCALITY �t
NEAREST
FOR APPLICANT TO FILL IN CROSS ST �(/ G- G
NO EACH FEE
RECEPT
$ $ OWNER
MAIL
LIGHT / TO AL FIRST 20 20 D ADDRESSi�n 'e '
SWITCH f � OVER 20 10 CITY TEL •NO
LIGHTING FIRST 20 20 PLAN CHECK
2O APPLICANT
FIXTURES OVER 20 10 ADDRESS
r I
RANGE_DRYER_WTR HTR CITY TEL NO
STA COOK_OISP F A U CO�JTRAC I-OR
SPACE HTR AIR COND
ADDRESS
CLOTHES WASH _DISHWASH CITY TEL NO
FA N_0THiER 1 00 LICENSE IJO CLASS
MOTORS TRANSFORMERS RATING
IND HEATERS ETC HP KW KVA I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS-REGULATING
0 — 1 1 00 ELECTRICAL WIRING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
1 — 10 3 00 LICENSED AS REOU IRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
' 10 — 50 5 00 RESIDE IN THE ABOVE SCAIPED SIDE NTIAL PROPERTY O
SO — 100 10 00 SIGNATURE d
U
OF PERMITTEE
100 — 500 15 00 H—
SIGN GAS
DIST ICT O GUPR N P&OCESSED
TUBE OR � w
SIGN AND ONE CIRCUIT 3 00 QB
'� ��✓ �
MARQUEE ADDITIONAL CIRCUITS 1 00 NOTES
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00 60
SERVICE OVER 600 VOLTS OR 200 AMP 5 00
TEMP SERVICE POLE &APPURTENANCES 3 00 APPROVALS DATE INSPECTOR S SIGNATURE
TEMP POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
PERMIT FEE (SUB TOTAL) WIRING A-7 • 1�
r
FIXTURES
PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED
PERMIT ISSUING FEE 2 00 00 UTILITY CO NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL Z6 (!
TOTAL FEE Q JOSEPH C ROO AN
SUPERVISING ELE AL ENGINEER
PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION _CK - M 0 CASH
r L�01 4 11� ,AUG13 2 D 5.40= a
IEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE