HomeMy Public PortalAbout5021 ENCINITA AVE_Electrical__ DBS-5A 3.55 APPLICATION FOR ELECTRIC PERMIT
DIVISION OF BUILDING AND SAFETY
Department of County Engineer
County of Los Angeles 'BUILD'NG � P2 r�
WM.J. FOX, COUNTY ENGINEER ADDRESS
CASSATT D. GRIFFIN, SUPT OF BUILDING /V
LOCALITY �+ /7�'
FOR APPLICANT TO FILL IN NEAREST ¢
PERMIT FEES cRoss ST.
' NUMBER EACH FEE
LIGHT OUTLETS ` OWNER
RECEPTACLES / 'V MDDRESSAIL 4
A ' en
�v
WALL SWITCHES
TOTAL OUTLETS _ 5¢ _ CITY TEL.NO.
ELEC. RANGES 25 ELECTRICIAN Q ed� '1:3. �- ✓E�r�'a/lC
' ELEC. HEATERS 25 ADDRESS,,�
KW EA CITY O.SAi�1 P/a�_st TEL.NO."4�) !Lg
FIXTURES 5 LICENSE NO.
NUMBER of LIGHT clRculrs DISTRICT NO. 11GROUP
I ZONE I READY FOR INSPECTION
NUMBER OF RECEPTACLE CIRCUITS �A` ( 4 _IMOTORS 3NUMBER HORSEPOWER FEE 77INSPECTION RECORD
NEW MVD. HP OVER INC. EACH �
LESS S .25
1i2 2 .50
2 5 1.00
5 15 1.50
15 50 2.50 �>>dt�`C� ���c,s� ��. r (_ 1
50 200 5.00
MISC.
s NO.SIGNS NO.TRANS.
NO.SIGNS NO. LAMPS
FOR EACH PERMIT,
WIRING $1.00
FIXTURES 51.00 ti
SUPPLEMENTARY .50 APPROVALS
TOTAL FEE 5 p`�' I DATE INSPECTORS SIGNATURE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APP IC TI(5N CONDUIT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY _
WITH ALL COUNTY ORDINANCES 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 1 AM THE LEGAL OWNER OF THE ABOVE POWER I
DESCRIBED RESIDENTIAL PROPERTY. R
SIGNATURE h UTILITY CO.NOTIFIED
OF PERMITTEE - FINAL
WILLIAM J. FOX, COUNTY ENGINEER VALIDATION A. C.VEIT,CHIEF ELECT. INSPECTOR
0..6 4" "9�ay 1 2 5.2 8
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