HomeMy Public PortalAbout5021 DOREEN AVE_Electrical__ 76A663-CE806 4-68
APPLICATION FOR
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COUNTY OF LOS ANGELES
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DEPARTMENT OF COUNTY ENGINEER ILD
BUILDING AND SAFETY DIVISION a.UDOREsINsG -5--oa,
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JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY J
NEAREST
FOR APPLICANT TO FILL IN CROSS ST a&J'u:�j NO. AC FEE
RECEPT/ID� S S OWNER � .o F
L��iL _ MAIL yy��
LIG.T_�TOTAL FIRST 20 .20 ADDRESS Se21 ./)Q /9a,'-
-SWITCH OVER 20 .10 (CITY /1 EL. NO.
P
LAI; CH CK
LIGHTING TOTAL FIRST 20 .20 APPLICANT
FIXTURES �.yy OVER 20 .10 ADDRESS
RANGE_DRYEAt2_WTR.HTR._ CITY TEL
STA.COO K_DIS P._F.A.U.— CONTRAC
SPACE HTR.—/A/IR COND.� ADDRESS - '
CLOTHES WASH.LOISHWASH._ L CITY TEL NC
FAN_OTHER 1.001 LICENSE NO. CLASS.
MOTORS,TRANS FORMERS RATING
IND. HEATERS. ETC. HP. KW, KVA. I HEREBY ACKNO DGE THAT I HAVE READ THIS APPLICATION
AN0 STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
0 00
HEREBY CERTIFY THAT y I AM NG DEEPLY REGISTERED AND/OF
1 lO 3.00 LICENSED AS REQUIRED M LOS ANGELES COUNTY 4N0 STATE OF
CALIFORNIA OR THAT 1 TH EGAL OWNER OP, ANO INT ENO T .
R 10 50 5,00 RESIDE IN, THE A f P PIPED RESIDE HTIAL PPOPERTY.
f 50 - 100 10.00 SIGNATURE d
OF PERMITTEE CD
U
100 - 500 15.00
SIGN,GAS DIS ICT N G Z p
1 TUBE, OR SIGN AND ONE CIRCUIT 3.00 P
vm
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y MARQUEE ADDITIONAL CIRCUITS 1.00NOTES: C_
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P; SERVICE NOT OVER 600 VOLTS OR 200 AMP 2,00 "V ?
SERVICE OVER 600 VOLTS OR 200 AMP 5.00
TEMP SERVICE, POLE, & APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP. POWER POLE
UNDERSLAS WORK
ROUGH CONDUIT
WIRING - Q
PERMIT FEE' (SUB TOTAL)
FIXTURES
PLAN CHECK FEE (50: PERMIT FEE) I l
POWER AUTHORIZED
PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL 7:/0
TOTAL FEE JOSEPH C. ROOHAN
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.0. CAS
I � 0224% JUL e3 2 U 6.00
IEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE - /l'/ /q//i✓