HomeMy Public PortalAbout5956 ENCINITA AVE_Electrical__ 76.663
BS-5A APPLICATION FOR ELECTRIC PERMIT qry
BS-5A 12-59 II
DIVISION OF BUILDING AND SAFETY iL
Department of County Engineer
County of Los Angeles
BUILD'
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WM. J. FOX. COUNTY ENGINEER ADDRESS,
CASSATT D. GRIFFIN, SUPT of BUILDING
FOR APPLICANT TO FILL IN , LOCALITY
PERMIT FEES NEAREST
CROSS ST.
NUMBER EACH
LIGHT OUTLETS OWNER r�y�
RECEPTACLES MAIL
'ADDRESS �� yZ—
WALL SWITCHES A ' � ,.
TOTAL OUTLETS SC_ $ - CITY i�yciyyt,�c� TEL. NO.
ELEC. RANGES 25 ,Y. ELECTRICIAN �0
ELEC. HEATERS 25 ADDRESS .J L
KW EA
FIXTURES 5 LICENSE NQ
NUMBER OF LIGHT CIRCUITS DISTRICT NO. I GROUP ZONE READY EOR INSPECTION
NUMBER OF RECEPTACLE CIRCUITS ✓r _.r .
.I I
MOTORS _
NUMBER HORSEPOWER FEE -INSPECTION RECORD
NEW MVD. HP OVER INC. EACH
I/$&LE.. $ .25
—— I/i_ 2 .50
— 2 5 1.00
5 15 1.50
_ 15 50 .2050 _
50 -200 5.00
MISC.
NO. SIGNS NO. TRANS.
NO. SIGNS NO. LAMPS
FOR EACH PERMIT: _
WIRING $1.00
FIXTURES $1.00
SUPPLEMENTARY .50 T
APPROVALS
TOTAL FEE ' $/ Z DATE INSPECTOR'S SIGNATURE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CONDUIT �
ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY rr•.y
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
CALIFORNIA OR THAT I AM THE LEGAL-'OWNER OF THE ABOVE POWER
DESCRIBED RESIDENTIAL PROPER T /
UTILITY CO. NOTIFIED r[�GNATURE
-s �'L.L�2CaA_liC-� FINAL ✓NL __
SIOF PERM TTEF V A
WILLIAM J. FOX, COUNTY ENGINEER VALIDATION -
{ 55✓ s 5S MAR T5 . 2 125
DEPUTY