HomeMy Public PortalAbout5029 DOREEN AVE_Electrical__ 76 S.5A APPLICATION FOR ELECTRIC PERMIT q'1
OBS..31254 tl'
DIVISION OF BUILDING AND.SAFETY diiYYY
Department of County Engineer
County of OU Angelos Bu1LDING I WM. J. FOX, COUNTY ENGCASSATT D. GRIFFIN. $OP'T OFFOR APPLICANT TO FILLINLOCALITYPERMIT FEES NEARESTCRSSSTNUMBER EACHLIGHT OUTLETS OWNER
IRECEPTACLES Z MAILADDRESSWALLSWITCHES ^TOTAL OUTLETS ii 5! S - CITY TEL O.'
ELEC. RANGES 25ELECTRICIAN
ELEC. HEATERS 25ADDRESS VKW EA CITY �JTEL.
FIXTURES 5 LICENSE NO. G
NUMBER OF LIGHT CIRCUITS
DISTRICT NO. GROUP ZONE READY ROR INSPECTiCN
NUMBER OF RECEPTACLE CIRCUITS
MOTORS \J
NUMBER HORSEPOWER FEE INSPECTION RECORD
NEW MVO. HP OVER �t INC. EACH
y{8 LESS § .25 -
_ _�
2 5 1.00 _
5 15 1.50 1
15 50 2.50 I
50 2 5.00
misc.
NO. SIGNS NO. TRANS. - -.
NO. SIGNS NO. LAMPS
FOR EACH PERMIT'
WIRING
FIXTURES $1.00
SUPPLEMENTARY
APPROVALS
TOTAL FEE § / /D DATE INSPECTOR'S SIGNATURE
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION CONDUIT
AND STATE THAT THE ABOVE IS CO
RRECTAGREE COMPLY W - //
WITH ALL COUNTY ORDINANCES AND STATETE LAWS REGULATING WIRING 3 57---3;J�JJ '�
ELECTRICAL WIRING. .
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REOUIRED BY LOS ANGELES COUNTY'AND STATE OF
CALIFORNIA OR THAT 1 AM TH LEG WNER OF THE ABOVE POWER
DESCRIBED RESIDE N _ OPE
SIGNATURE UTILITY CO. NOTIFIED u.Cr e
OF PERMITFE Y FINAL
WILLIAM J. FOX, COUNTY ENGINEER VALIDATION
,moi o'6 2r.':asi� 2, '2 1::1 O
BY ... .-. ....
DEPUTY
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".-SA1254 APPLICATION FOR ~ELECTRIC PERMIT 1
Defi�fiA
DIVISION OF BUILDING AND SAFETY
Department of County Engineer
County o1 Los Angeles
WM. J. FOX. COUNTY ENGINEER C
CASSATT D. GRIFFIN,.SUP'T OF BUILDING
FORA, =WM5=J"
APPLICANT TO FILL IN LOCALITY
PERMIT FEES CROSS sr. IUf=-s-T
-
PERMIT
I
NUMBER EACH A.. d R S L.�
LIGHT OUTLETS. ' OWNER t /r /!'R
RECEPTACLES 2 Z. ! MAIL
ADDRESS
WALL SWITCHES
TOTAL OUTLETS .�'� 56 S CITY TEL. NO.
ELEC. RANGES 25 ELECTRICIAN
/ /OM!_�' t6C
ELEC. HEATERS 25 ADDRESS
KW EA �/y CITY• p4 jr,/4�/�/� / TEL. NO.
FIXTURES ! g
!!!! LICENSE NO. `
NUMBER OF LIGHTCIRCUITS.
NUMBER OF RECEPTACLE DISTRICT NO. GROUP ZONE READY coq INSPECTION
CIRCUITS Ir- ? ^ /
• MOTORS - -f/ /T '
NUMBER HORSEPOWER . FEE INSPECTION REC_ORD ,,
NEW MVD. HP OVER INC. EACH
2 1/28 LESS $ .25 C ��/ ! /�// �F ^_✓"/•�
yi .2 .50. �d�/-'Ht /h VL/H//_- /%
-2 5 1.00 �x
--_ 5 •IS 1.50
is 50 2.50
50 200 5.00
MISC.
4
NO. SIGNS NO. TRANS. -
NO. SIGNS NO. LAMPS __
FOR EACH PERMIT: '
WIRING $1.00 Q
FIXTURES $1.00 _j_ UO -
SUPPLEMENTARY .50
p`— APPROVALS
TOTAL FEE S `'•® DATE INSPECTOR'S SIGNATURE
I HEREBY•ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CONDUIT d It
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO'COMPLY
I WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING
ELECTRICAL WIRING.
I HEREBY CERTIFY THAT I AM PROPERLY. REGISTERED AND/OR FIXTURES h
LICENSED AS REQUIRED BY LOS ANGELES' COUNTY AND STATE OF POWER
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
SIGNDESCRATURE RES IDENT]ALw FNO�q;� UTILITY CO. NOTIFIED
SIGNATURE \\'.�5CC ,TJJ /
OF PERMITTEE • FINAL
WILLIAM J. FOX, COUNTY.ENGINEER _VA��(L��IDATION p `
a1L01-9 S 7n X 28
r..
DEPUTY '-
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