HomeMy Public PortalAbout5734 CLOVERLY AVE_Electrical__ 76A663-CE ,G,74 'APPLICATION FO EL'ECTRI PER T ' y A,
COUNTY OF LOS ANGELES
t't/ DEPARTMENT OF COUNTY ENGINEER fOB �
BUILDING,AND SAFETY DIVISION DDRESS lc
t OCALITYEAREST ^s
FOR APPLICANT TO FILL IN 5 CROSS ST '
OUTLETS NO EACH I FEE OWNER OR
FIRM NAME
RECEPT MAIL
LIGHT TOTAL
` FIRST 20 " 25 ADDRESS
CIT TEL N 00
j
SWITCH_ 9 OVER 20 f0 1 PLAN CHEC
If
' FIRST 20 25 APPLICANT'
LIGHTING �' i
TOTAL
FIXTURES
OVER 20 f0 ADDRESS
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RESIDENTIAL APPLIANCES CITY EL NO
PERMIT "
RANGE DRYER_WTR HTR APPLICANT r
STA COOK DISP, ^F A U ADDRESS
SPACE HTR AIR CONO H CITY " TEL NO _ 7
CLOTHES WASH DISHWASH LICENSE OR -- CLASS
/
_REG_NUMBER_
FAN OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS-APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS TRANSFORMERS ti RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND HEATERS, ETC HP KW KVA ' ELECTRICAL WIRING
SIZE & TYPE OVER w TO, '
., r I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR
0 — I 100 <LICENSED AS REQUIRED SY LOS ANGELES COUNTY AND STATE OF b
CALIFORNIA OR THAI I,'AM THE LEGAL OWNER OF THE ABOVE
' 1 — 10, _300 14'v DESCRIFE0 RESIDDE�TIAL PPIOPERTY {J CD
PERM I TEE
' 10 - 50 500 SIGNATURE
F-
50 - 100 1000 DISTRICT NO 1^11 U
C ED BY W
� � O�
100 - 500 1500 Z
SIGN GAS SIGN AND ONE CIRCUIT 500 T APPROVALS DATE INSPECTO 'S SIGNATURE
TUBE OR
MARQUEE ADDITIONAL CIRCUITS 100 TEMP POWER POLE
SERVICENOTOVER 600VOLTSOR 200AMP 300 Lle
U UNDERSLAB WORK
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SERVI CE OVER 600 VOLTS OR 200 AMP 1000 ROUGH CONDUIT 8
TEMP SERVICE, POLE, &APPURTENANCES 500
WIRING �1
TEMP LIGHT OR RECEPT SYSTEM 300 FIXTURES
POWER AUTHORIZED
UTILITY CO NOTIFIED Y}�lIVJ
FINAL
PERMIT FEE (SUB TOTAL) NOTES
PLAN CHECK,FEE
PERMIT ISSUING FEE 300
TOTAL FEE
PLAN CHECK VALIDATION CK M D CASH PERMIT VALIDATION M 0 y CASH =
2�0 s 2`0- . 1-':5 51 0 i&,
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
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76A6f',CEr 806(6/78) APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES a l BUILDINGAANDSAFETY
I
FOR APPLICANT TO FILL IN JOB ,
New Residential Bldgs &Pools EACH NO FEE ADDRESS � 3 U�r r V�
1 &2 Fomily Sq Ft $ 025 — $ LOCALITY
Multi family Sq Ft 02 NEAREST
CROSS ST O 4 H
Residential Swimming Pools ' 25 00 OWNER ORE ` 3
S FIRM NAMK+�
Outlets RecLi ht Sw 50 _L - L%MAIL /�
g First 20 ADDRESS s 3 ,QUe r
Total No Additional 30 CITY Tel
PLAN CHECK
APPLICANT
Lighting Fixtures First 20 50 VAADDRESS
Total No
1_ Additional 30 CITY Tel-No
I
Fixed Appliances Not Over 1 HP _ PERMIT
Range— APPLICANT
Heater_D W
Oven—Dryer_W M"— ADDRESS �+
Top _FAU _ W H CITY Tel No
Hood—Fan _Other LICENSE OR
Disp —Room Air Cond 2 50 REG NUMBER Class
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA
Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO
COMPLY WITH ALL-COUNTY ORDINANCES STATE S
Size&Type HP KW KVA or KVAR
REGULATING ELECTRICAL WIRING d
2 50
Up to 1 InI HE Y RE I T
RTIFY THAT I AM PROP D/OR
Over 1 to 10 Incl 5 00 r LICENSED AS QUIRED BY LOS ANGEL CO 1T ATE OF
Over 10 to 50 Incl 12 50 CALIFORNIA R�99 THAI AM THE LEG L OW E ABOVE C
DESCRIBED SIIPENTIA PROPERTY
Over 50,to 100 Inc 25 00' PERMITEE //
Over 100 - 4000 _
SIGNATUR
Services - DISTRIC N - s, = P S B
v 0 200 Amp Under 600V 2 50
201 1000 Amp Under 600 V - 25 00Over 1000 Amp or Over 600 V 50 00 Z
Temp Power Pole&Appurtenances 1000
Q
Sign with One Branch Circuit v r 1000 C
Additional Sign Branch Circuits 2 00 INSPECTION >
INFORMATION " Y
Misc Conduits&Conductors 1000 ON REVERSE = 1
Other(See Complete Fee Schedule) SIDE Z 2 2 6 1.2 A
g J # 0 0 o 0 o 2
PERMIT FEE _ (Sub TotaU- 20 . 11,50
PLAN CHECKING FEE (One Fourth Permit Feel 0 1 1,5 0 v
PERMIT ISSUING FEE $7 00 0206-79
r
TOTAL FEE f.SCJ >
INSPECTION FINALED W
,date ^�;? BY (es,! FF°° f t '