HomeMy Public PortalAbout5813 CLOVERLY AVE_Electrical__ 76A663-CE806 3-69 e,'
APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING L" /3
BUILDING AND SAFETY DIVISION S
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JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS, SUPERINTENDENT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN ST
CROSS ST S
CROSS
NO EACH FEE
$ $ OWNER
RECEIPT / MAIL
LIGHT TOTAL
FIRST 20 G 20 B ADDRESS
SWITCH OVER 20 10 CITY TEL NOPLAN CHECK
LIGHTING TOTAL FIRST 20 20 APPLICANT
FIXTURES } OVER 20 10ADDRESS
RANGE_DRYER_WTR HTR CITY TEL NO
STA COOK _DISP � F A U _ _ _p e CONTRACTOR _ 9
SPACE HTR AIR COND ADDRESS
CLOTHES WASH _DISHWASH CITY Zple- 4�1 TEL NO 3�?
FAN OTHER 1 00 LICENSE NO /6Io,S CLASS �U
MOTORS,TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
IND HEATERS ETC HP KW KVA AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING
0 - 1 1 00 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR }
CL
LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATEOF O
I - 10 3 00 CALIFORNIA OR THAT I AM THE LEGAL OWNER AND INTEND TO V
RESIDE IN THE ABO RIBED RESIDEN PROPER Y
10 - 50 5 00 OC
50 - 100 10A0 SIGNATURE ' O
OF PERMITTEE 'N U
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100 - SOO 1500 DISTRICT NP
NO /y GRO ZON R N
SIGN,GAS SIGN AND ONE CIRCUIT 3 00 V /] Z
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1 00 NOTES
SERVICE NOT OVER 600 VOLTS OR 200 AMP f 2 00 Q 4P
SERVICE OVER 600 VOLTS OR 200 AMP 5 00
TEMP SERVICE, POLE, &APPURTENANCES 3 OO APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT q,
WIRING -7O
PERMIT FEE (SUB TOTAL) FIXTURES
POWER AUTHORIZED
PLAN CHECK FEE (50% PERMIT FEE)
PERMIT ISSUING FEE 2 00 00 UTILITY CO NOTIFIED - O f
SUPPLEMENTARY PERMIT ISSUING FEE 1 00
FINAL 7
TOTAL FEE �� JOSEPH C ROOHAN
SUPERVISING ELECT ENGINEER
PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION OK M O CASH
.20-SI Ar,,5 4 7 9 2 D 520-
SEF
EF BACK OF APPI ICATION FOR COMPLFTE FEE SCHEDULE