HomeMy Public PortalAbout5106 FARAGO AVE_Electrical__ 76A663 CE806 10,74 APPLICATION FORqLECTRICAi PERMIT Sul
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER JOB O / ���� �{
BUILDING AND SAFETY DIVISION ADDRESS ld
NFlic
LOCALITY
NEAREST p -
FOR APPLICANT TO FILL IN CROSS ST iL
OUTLETS NO EACH I FEE FIRM NAME
RECEPT $ $ MAIL
LIGHT TOTAL
FIRST 20 ADDRESS A
CITY TEL NO
OVER 20
SWITCH 1 . 10 PLAN CHECK +
FIRST 20 25 APPLICANT
LIGHTING T L
FIXTURES OVER 20 10 ADDRESS
RESIDENTIAL APPLIANCES CITY C'„ TEL No
PERMIT
RANGE DRYER_WTR HTR APPLICANT
STA COOK DISP Y F A U ADDRESS n
SPACE HTR AIR COND CITY TEL NO
CLOTHES WASH _ DISHWASH REGENNUMBER CLASS
FAN OTHER �� I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND HEATERS ETC HP KW KVA ELECTRICAL WIRING
SIZE & TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAI I AM THE LEGAL OWNER OF THE ABOVE
a
1 - 10 300 0ESCRIPED RESI NTIAL PROPERTY c)
U
PERMITEE 1
10 - 50 5001 SIGNATURE c:)
I.-
U
50 - 100 1000 uJ
DISTRICT NOP ED BY �-
Q Ln
100 - 500 1500 � Z
tj
SIGN GAS SIGN AND ONE CIRCUIT 500 APPROVALS DATE INSPECT SSIGNATURE
TUBE OR
MARQUEE ADDITIONAL CIRCUITS 100 TEMP POWER POLE
SERVICENOTOVER 600 VOLTS OR 200 AMP 300 UNDERSLAB WORK
SERVICEOVER 600 VOLTS OR 200AMP 1000 ROUGH CONDUIT _
TEMPSERVICE POLE &APPURTENANCES 500 x WIRING ��,�•�� �-ti,t
TEMPbLIGHT OR RECEPT SYSTEM 300 FIXTURES
POWER AUTHORIZED
UTILITY CO NOTIFIED
C
" FINALo'�,
PERMIT FEE (SUB TOTAL) NOTES
PLAN CHECK FEE
PERMIT ISSUING FEE 300
TOTAL FEE
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION K M O CASH
a 569rOCT 8 2 0 3875A018
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE -�