HomeMy Public PortalAbout6380 ENCINITA AVE_Electrical__ %6A663 CE,8^6R 9/96 APPLICATION FOR ELECTRICAL PERMIT
• • COUNTY OF LOS ANGELES
'DEPARTMENT OF COUNTY ENGINE E R JOB
BUILDING AND SAFETY DIV ISION ADDRESS
FOR APPLICANTTO FILL IN LOCALITY
New Residential Bldgs.&Pools EACH NO, FEE NEAREST
I &2-Fomily,Sq.Ft. $ .025 — $ - .CROSS ST.
Multifamily Sq. F. ' OWNEROR.02 — FIRM NAME
Residential Swimming Pools MAIL r,y�
JO ADDRESS
Outlets:Rec light_Sw. CITY Tel.No.
First 20 .50 PLAN CHECK.
Total No. Additional .30 APPLICANT
ADDRESS
Lighting Fixtures First 20 .50 CITY Tel.No.
Total No.. Additional '30 PERIT
APPLICANT L
Fixed Appliances Not Over I HP ADDRESS 'r
Range_Heater_D.W._ CITY Rf��f Tel. No Zj
Oven —Dryer—W.M.— LICEN E OR
Top —FAU —W.H._ REG.NUMBER CIcsAr
Hood— Fan _Other— 25° HEREBY ACKNOWLEDGE THAT HAVE READ THIS APPLICATION AND STATE
Disp. — Room Air Cond. • �" THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDIN.
ANCES AND STATE LAWS REGULATING ELECTRICAL WIRING.
Power Apparatus&Large Appliances
Size&Type HP, KW,KVA,or KVAR I HEREBY CERTIFY 111011'11A.PROPERLY REGI RED / LICENSED AS
REQUIRED BY LOS ANG S COUNTY AND STATE F CAL NI OR THAT I AM
Up tat Ind. THE LEGAL OWNEROf E VEDEXRIBED RE ENTI ROP tT.
Over 1 to 10 Ind. 4-/L' 5.00 J d
Over 10 to 50 Ind 10.00 PERMITTEE
Over 50 to 100 Inc. 20.00 SIGNATURE
30.00 cc
Over 100 DISTRICT NO. OCESS BY 0
Services ` •Q� r
0-200 Amp.Under 600 V /00.4 12.50
1
25.00 APPROVALS DATE 5 GNATOURE Z
201-1000 Amp.Under 600 V '
Over 1000 Amp.or Over 600 V 50.00 TEMP. POWER POLE
UNDERSLAB WORK
Temp. Power Pole 8.Appurtenances 10.00 ROUGH CONDUIT
Sign with One Branch Circuit 10.00
Additional Sign Branch Circuits 2.00 WIRING
Misc.Conduits&Conductors 15.00 FIXTURES
Other(See Complete Fee Schedule) POWER AUTHORIZED
UTILITY CO.NOTIFIED
FINAL
PERMIT FEE (Sub-Total) NOTE ORKERS COMEENcza
PLAN CHECKING FEE (One-Founh Permel'ittfe
PERMIT ISSUING FEE SO 00,j/y� ) /? ,9;►7 POLICY HOLDER:
TOTAL FEE loco POLr I ^o --��-�
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION K. ' M.O. CASH
352-�JUL 5 2 U 24_.5_ 0A5i
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
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