HomeMy Public PortalAbout10018 DAINES DR_Electrical__ DBS-5A I2-Bq; APPLICATION FOR ELECTRIC PERMIT
DBS-5A
DIVISION OF BUILDING AND SAFETY
It Department of County Engineer
t" County of Los Angeles BUILDING
WM. J. FOX, COUNTY ENGIMEER ADDRESS
CASSATT D. GRIFFIN, SUPT OF BUILDING
FOR APPLICANT.TO FILL IN LOCALITY �J
PERMIT FEES ` NEAREST
ST L.
FEE CROSS
NUMBER EACH
LIGHT OUTLETS OWNER [-•f O2 �
sV Z&eloc�-��.
RECEPTACLES MAIL -�
ADDRESS F
WALL SWITCHES
TOTAL OUTLETS 50 S LS CITY E � L/= I / • TEL NO
ELEC RANGES 25 k ELECTRICIAN �p
ELEC HEATERS 25 ADDRESS SYL, I
KW EA CITY -��C 1 TEL NO
FIXTURES 5 LICENSE NO
NUMBER OF LIGHT CIRCUITS
NUMBER OF RECEPTACLE CIRCUITS DISTRICT NO GROUP ZA.ON READY FOR INSPECTION
����0�
MOTORS �]
NUMBER HORSEPOWER FEE INSPECTION RECORD
NEW MVD HP OVER INC EACH `1
_ 1�2&LESS S .25
1/2 2 50
_ 2 5 100
5 15 1 50
I5 50 250
50 200 �-5 00
M 1 Sc.
4 _
NO SIGNS NO TRANS _
.NO SIGNS NO LAMPS ��W Z ����� �'
FOR EACH PERMIT �'
WIRING S•1 00 -7720 -
FIXTURES SI 00 -
SUPPLEMENTARY .50
/ .� . APPROVALS
TOTAL FEE DATE INSPECTOR'S SIGNATURE
I HEREBY ACKNOWLEDGE THAT '1 HAVE READ THIS APPLICATION CONDUIT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES, AND STATE LAWS REGULATING WIRING '
ELECTRICAL WIRING '
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF Ip01NER -
CALIFORNIA OR THAT I AM THE LEGAL OW ER OF THE ABOVE _
DESCRIBED RESIDENTIAL PROPERTY. _
w.^' UTILITY CO NOTIFIED
SIGNATURE p •
FINAL
OF PERMITTEE / (/
WILLIAM J. FOX, COUNTY ENGINEER VALIDATION-
�, 1 .1 519
DEPUTY
,�DBS-5A5S APPLICATION FO ELECTRIC PERMIT �.
•• 'DIVISION OF BUILDING AND SAFETY
Deportment of County Engineer BUILDING
County of Los Angeles ADDRESS a&Z
WM.J. FOX, COUNTY ENGINEERADDRESS
CASSATT D. GRIFFIN. SUPT OF BUILDING
LO^ALITY `�
FOR APPLICANT TO FILL IN NEAREST
PERMIT FEES CROSS ST 1
NUMBER EACH FEE
OWNER O
LIGHT OUTLETS
RECEPTACLES MAIL �, 2
ADDRESS tl J
WALL SWITCHES
TOTAL OUTLETS 5¢ $ CITYTEL NO
ELEC. RANGES 25 ELECTRICIAN
_ELEC HEATERS 25 ADDRESS
KW EA CITY TEL. NO
FIXTURES 5 LICENSE NO
NUMBER OF LIGHT CIRCUITS ommmsmalmom
- DISTRICT NO. I GROUP I Z� READY FOR INSPECTION
NUMBER OF RECEPTACLE CIRCUITS r
MOTORS
+����
NUMBER HORSEPOWER FEE /' INSPECTION RECORD
NEW MVD HP OVER I INC EACH
{�
1/2&LESS $ .25
5 15 1.50
15 50 2 50
50 200 500
misc.
NO SIGNS NO TRANS. '
NO SIGNS NO LAMPS
FOR EACH PERMIT
WIRING S1.00 -•
FIXTURES $100
SUPPLEMENTARY 50 APPROVALS
TOTAL FEE Is DATE INSPECTOR'S SIGNATURE
1 HEREBY ACKNOWLEDGE THAT-[ HAVE READ THIS APPLICAT16N CONDUIT _
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY _�►y �,�'
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING AO'"-J
ELECTRICAL WIRING.
1HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE 'ABOVE POWER
DESCRIBED RESIDENTIAL RTY.
SIGNATURE
UTILITY CO.NOTIFIED
OF PERMITTEE r FINAL
WILLIAM J. FOX, COUNTY ENGINEER- VALIDATION A.C.VEIT,CHIEF ELECT. INSPECTOR
.'Co 8 9 8 0 l^ OCT 14 2 6.0 5
0