HomeMy Public PortalAbout6043 CLOVERLY AVE_Electrical__ 76A663-CE80610/74 APPLIC TIO OR EL RICAL PE IT `
COUNTY OF LOS ANGELES /�+
DEPARTMENT OF COUNTY ENGINEER ADDRESS Gj a
BUILDING AND SAFETY DIVISION
LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST L
OUTLETS NO EACH I FEE OWNER OR
$ $ YME `� ? 1� �VF
RECEPT� v/
�
MAIL �7
LIGHT TOTAL
FIRST 20 ADDRESS 't4 L.�✓
SWITCH_ OVER 20 10 CITY TEL NO
PLAN CHECK
LIGHTING TOTAL FIRST 20 ZS APPLICANT
FIXTURES
OVER 20 10 ADDRESS
-
RESIDENTIAL APPLIANCES CITY TELNO
PERMT
RANGE DRYERI)WTR HTR APPL IICANT Lowy !ry
STA COOK DISP F A U ADDRESS
SPACE HTR AIR COND CITY TEL NO 2
CLOTHES WASH DISNWASH REGE NUMBER 5 C3 CLASS (!:
FAN OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 19 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 h TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 - 1 100 LICENS EO A8 REDU IRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAI I AM THE LEGAL OWNER OF THE A OVE CL
1 - 1O 300 DESCRIPED RESIDENTIAL Pq OPERTY O
U
PERMITEE
10 - 50 500 SIGNATURE „CD
U
` 50 - 100 1000 DISTRICT NO PRO ESSED Y ILL
a
100 - 500 taoo 1:5 c D 8 z
SIGN, GAS SIGN AND ONE CIRCUIT 800 APPROVALS DATE INSPE R'S SIGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 100 LTEMP POWER POLE
SERVICE NOT OVER 600 VOLTS OR200AMP 300 S UNDERSLAB WORK
SERVICEOVER600VOLTS OR200AMP 1000 ROUGH CONDUIT
TEMPSERVICE, POLE, &APPURTENANCES �. 800 WIRING
TEMP LIGHT OR RECEPT SYSTEM 300 FIXTURES
POWER AUTHORIZED
UTILITY CO NOTIFIED
FINAL
PERMIT FEE (SUB TOTAL) NOTES
PLAN CHECK FEE
PERMIT ISSUING FEE 300
TOTAL FEE
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M 0 CAS
V�
1 8 9 i`nEC 8 2 1) 1 1.4 0
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE