HomeMy Public PortalAbout5940 CLOVERLY AVE_Electrical__ 76A663-CE006 10/74 APPLICATION, FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER .JOB
BUILDING AND SAFETY DIVISION ADDRESS d pr
LOCALITY e,,
NEAREST
FOR APPLICANT TO FILL IN CROSS ST AJpQ-
OUTLETS NO EACH I FEE OWNER OR
RECEPT
FIRM NAME c}
yT $ S ADDRMAILESS�/ 0 C"�O VC�Y l
LIGHT TOTAL FIRST 20 25 �Q
OVER 20 CITY gft-m �{ �i TEL
SWITCH_ ID PLAN CHECK
LIGHTINGTOTAL FIRST 20 25 APPLICANT
FIXTURES
OVER 20 10 ADDRESS °
'
RESIDENTIAL APPLIANCES CITY TEL NO
RANGELDRYER_WTR HTR APPLIPERMICTANT
STA-COOK DI SP F A U ADDRESS lej
SPACE HTR AIR COND CITY !t_2 TEL NO
CLOTHES WASH DISHWASH LICENSE OR _
REG NUMBER CLASS a
FAN OTHER 100 ` Q 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING WITH 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
0 - I 100 LICENSED A9 RED IRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER F THE ABOVE d
10 300 PERMITEE DESCRIPED RESIDENTIAL ERT O
U
r
10 - 50 600 SIGNATURE 71^"C ` O
I--
50 - 100 1000 U
DISTRICT NO PROCES&ED BY
W
Q o-
1 00 - 500 15001
SIGN, GASSIGN AND ONE CIRCUIT 500 APPROVALS DATE INSPECTOR'S SIGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 100 TEMP POWER POLE
SERVI CENOT OVER 600 VOLTS OR 200 AMP 300 3 UNDERSLAB WORK
SERVICEOVER600VOLTS OR200AMP 1000 ROUGH CONDUIT
TEMPSERVICE,POLE, &APPURTENANCES 500 WIRING G3�tv5
TEMP LIGHT OR RECEPT SYSTEM 300 FIXTURES
POWER AUTHORIZED
UTILITY CO NOTIFIED
FINAL
PERMIT FEE (SUB TOTAL) NOTES ✓
PLAN CHECK FEE
PERMIT ISSUING FEE 3001 Id
TOTAL FEE 5011
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M 0 CAB
4 2 81--SEP 2 2 0
.5 0
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE I
OBS
]DEPARTMENT OF D i RDIING AND SA ri l 8 I
, CATION FOR PERWr
COUNTY OF LOS ANGMS ELECTRIC- 1
J FOX. cHI ENGINEER A
z DISTRICT NO. GROUP �ZNE PERMIT NO.
t
NAME Z 7 � � ?;f
aDDREssREC
I READY FOR// TE
CITY TEL NO gD C �V� /B/Y FIRST INSPECTION C7`?ISSUE]/DCOUNTY- ��+
m 0 EXP!CERT NO Z BS
APPLICANT FILL IN EWAVII.Y OLMINM PORTION ONLY
OS
IIRSCRII.''�ION OF WORK ADDRESS 2 D Z
NUMBER OF OUTLETS ON C4RCU1TS LOCALITY
LOCATION BY AOOMB NHAREST
LIGHT OUTLETS Isw I PLUGS frMT CROSS
CIRCUIT A B CID E F G H Nld AMErt' U
MAIL
3 ADDRESS
O '
CITY TEL NO
AAM THE LEGAL POSrt SOR OF THE ABOVE LOB
GRI-ma COON F U !CATION.
1
ELECTRICIAN
I AM THE LEGAL OWNER OF THE PROPARTY DESCRIBED
ABOVE
• OWNER
CORRECHONS
— a
z
2
a
- o
TOTA S
NO OF OUTLETS 7— APPROVALS
NO OF FIXTURES $ D DATE INSPECTOR'S NAME
NO OF MOTORS HIM $ CONDUIT 1 - , l/y
NO OF SIGNS TRANS $ WIRINGS ...
C ��
NO OF RANGES OR HEATERS $ FIXTURES
LT,02TAL
$ POWER ` ~
RMIT FEE $ �� UTILITYCO NOTIFIED
, FINAL