HomeMy Public PortalAbout5750 CLOVERLY AVE_Electrical__ 76A663-CE80610/72 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER JOB
BUILDING AND SAFETY DIVISION ADDRESS 7 ~0
LOCALITY,�
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
OUTLETS NO. EACH FEE OWNER OR
S $ FIRM NAME
RECEPT. MAIL
LIGHT TOTAL
FIRST 20 25 ADDRESS ✓ //
CITY L C 7 TEL. NO.
SWITCH OVER 20 1p
PLAN CHECK
LIGHTING TOTAL
FIRST 20 .25 APPLICANT
FIXTURES
OVER 20 .10 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL. NO.
PERMIT
RANGE DRYER_WTR. HTR._ APPLICANT
STA. COOK DISP. F.A.U. ADDRESS
SPACE HTR, AIR COND. CITY -.. Cs` TEL.
OR
CLOTHES WASH. 'DI SH WAS H. REG.NSE UMBER . ,.,�/ �! L._. CLASS. c—
FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING W,ITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING.
SIZE & TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
O — 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAI I AM THE LEGAL OWNER OF THE ABOVE
1 — 10 3.00 DESCRIPED RESIDENTIAL PROPERTY.
PERMITEE I/2 yf2,z„ el sw'�. O
T Gb U
10 — 50 5.00 SIGNATURE ot
O
50 — 100 10.00 DISTRICT NO. PROCESSED BY W
100 — 500 15.00 /p
• c
SIGN, GAS SIGN AND ONE CIRCUIT 5.00APPROVALS DATE INSPECTOR'S SIGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE
SERVICENOTOVER 600VOLTS OR200AMP 3.00 UNDERSLAB WORK
SERVICEOVER600 VOLTS OR 200AMP 10.00 ROUGH CONDUIT
TEMPSERVICE, POLE, &APPURTENANCES 5.00 WIRING
TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES
POWER AUTHORIZED '
UTILITY CO. NOTIFIED 3'3 _
FINAL
PERMIT FEE (SUB TOTAL) NOTES:
PLAN CHECK FEE
PERMIT ISSUING FEE 3.00 J &-i
TOTAL FEE �.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.0. CASH
AK j_1
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE