HomeMy Public PortalAbout5933 CLOVERLY AVE_Electrical__ DS 5-A 12 43 25M APPLICATION FOR PERMIT
DEPARTMENT OF BulLDnvc AND SAFETY ELECTRIC
�
COUNTY OF LOS ANGELES
WM J FOX CHIEF ENGINEER i
Q NAME .a� c� uS+ � I DISTRICT.NO. G�R/OTUP ZONE PERMIT NO.
ADDRESS,i `T ii ,�/ 6
�%3 RECEIVED BY READY FOR DATE ISSUED
CITY TEL NO 0« FIRST INSPECTION
� COUNTY /
CERT NO 7 d Z0 EXPIRES
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
DESCRIP'T'ION OF WORD JOB
ADDRESS 23 01 (�o V F�-121-
NUMBER OF OUTLETS ON CIRCUITS i LOCALITY L a
LOCATION BY ROOMS
NEAREST A /Y*L$
LIGHT OUTLETS SW PLUGS FIXT CROSS ST PT / ./+.r/j�/'/�/� y�
CIRCUIT A B C D E F G H ', w NAME I �1 � / / //� v H/A- l
Z MAIL
3
ADDRESS /2—
O
CITY TEL NO
I AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE O QUALIFICATION.
d ELECTRICIAN
F I AM TH6 LEGAL OWNER OF THE PROPFWY DESCRIBED
ABOVE
OWNER
CORRECTIONS
/7/O�Cl t
J
Q
Z_
O_
O
TOTAL
NO OF OUTLETS $ APPROVALS
NO OF FIXTURES S DATE INSPECTOR'S NAME
NO OF MOTORS H P $ v CONDUIT
NO OF SIGNS TRANS >$ WIRING
NO OF RANGES OR HEATERS $ FIXTURES
MISCELLANEOUS $ /1 POWER
PERMIT FEE S UTILITYCO NOTIFIED
TOTAL FEE FINAL
-IDB 13-A 10-41 25M { r-- -� _PEI —
APPLICATION Y''OIt 1'
pEPARTMENT OF BUILDING AND S "TIY r J��������
COUNTY OF LOS ANGELES
WM J FOX.CHIEF ENGINE
�T NAME 6 �,4� � c'� a'�` r DISTRICT NO,, GROUP ZONE PERMIT NO.,
ADDRES _5
CITY %J TEL NO f RECEIdID By READY FOR DATEISSUED
�m L/�� � FIRST INSPECTIONCOUNTY T
o+ CERT NO EXPIRES �rv a
�H
APPLICANT FILL IN �X OUTLINED PORTION ONLY
JOB DESI.�+RI TION OF WORK ADDRESS � _ ' .�A�4 ` `
NUMBER OF OUTLETS ON CIRCUITS LOCALITY
LOCATION BY ROOMS NEAREST
LIGHT OUTLETS SW PLUGS FIXT CROSS ST
CIRCUIT A I B C I D I E F 6 H 0 NAME
wMAIL
r • ADDRESS
O
CITY TEL.w0
I AM THE LEGAL POSSESS OF 7"E ABOV LOS
ANQW-ES COUHTX CERTIFI OF 1CLIFICAT�s
HLECTRICIAN
Y AM THE LEGAL;OWNER OF THE PROPERTY DESCRIBED
ABOYR
OWNER
CORRECTIONS
,
0
,
OTA
NO OF OUTLETS 7 APPROVALS
-7
NO OF FIXTURES / DATE INSPECTOR'S NAME
NO OF MOTORS H P, / *i , CONDUIT
NO OF SIGNS TRANS WIRING
NO OF RANGES OR HEATERS ffi ! FIXTURES
MISCELLANEOUS POWER �1
PERMIT FEE UTILITYCO NOTIFIED A
TOTAL FE
!� FINAL