HomeMy Public PortalAbout9313 DAINES DR_Electrical__ .76A663 �. APPLIC
��M/A Y �ON....FOR ELEC B U 9I,`O.d� PERMIT
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DBS-5A 3-SS
DIVISION OF BUILDING AND SAFETY
Department of County Engineer
-� County of Los Angeles BUILD ISS
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WM.J. FOX. COUNTY ENGINEER ADDRE
CASSATT D.GRIFFIN.SUPT OF BUILDING A
RUM LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PERMIT FEES CROSS ST.
NUMBER EACH FEE
OWNERC
MAIL
LIGHT OUTLETS v
�y •
RECEPTACLES CJ ADDRESS
WALL SWITCHES
TOTAL OUTLETS _ 5¢ '$ 14, CITY TEL.NO.
ELEC. RANGES 4- e
✓ 0j' 02— 25 • 4-0 ELECTRICIAN /81 i to .r ete bt
_ELEC. HEATERS "ems .25 O�d ADDRESS Sia �4,I I sJ
KW EAI 'CITY , (..gyp 04 'k,01 ,A TEL.N& �1�V
FIXTURES .�-/ 5 LICENSE NO.
NUMBER OF LIGHT CIRCUITS - DISTRICT NO. I GROUP.I ZONE I READY FOR INSPECTION
NUMBER OF RECEPTACLE CIRCUITS j� nj
MOTORS ej / L
NUMBER HORSEPOWERFEE INSPECTION RECORD
.
NEW MVD. HP OVER I INC. EACH
1/2'&LESS $ .25
1/z 2 .50
2 5 1.00
.5 15 1.50 -
15 50 2.50
.'50 200- 5.00
MISC.
NO.SIGNS NO.TRANS. -
NO.SIGNS,. NO.LAMPS
FOR EACH PERMIT: -
WIRING $1.00 "O
FIXTURES + ' $1.00 O''p
SUPPLEMENTARY - .501 11 APPROVALS
TOTAL FEE $/� C>- DATE INSPECTOR'SSIGNATURE-
I HEREBY ACKNOWLEDGE THAT I HAVE-READ THIS APPLICATION CONDUIT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINAN CES AND STATE LAWS REGULATING WIRING
ELECTRICAL WIRING.
I HEREBY 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 RESIDENTIARTX.
_•'.a/!�i�� k UTILITY CO. NOTIFIED
SIGNATURE
OFPERMITTEE� FINAL 4e
WILLIAM J. FOX, COUNTY ENGINEER VALIDATION A. C.VEIT.CHIEF ELECT. INSPECTOR
0 8 s 2 ucT. 2 - 2 1 0.10