HomeMy Public PortalAbout4515 FIESTA AVE_Electrical__ 176Af19S E806B 12/75 APPLICATION FOR ELECTRICAL PERMIT
BUILD AND SAFETY DI SION
FOR APPLICANT TO FILL IN JOBS/ S qr
New Residential Bldgs &PoolsEACH NO FEE ADDRESS1 &2 Finally Sq Ft $ — $ LOCALITY
Multi family Sq Ft — NEARESTCROSSSTResidential Swimming Pools OWNER ORFIRM NAMEOutlets Light Switch& Receptacle d ADDRESS �/ s I—ZE1,4
AI L
First 20 '�
Additional CITY FG/V) � 1 Tel No
PLAN CH K
Lighting Fixtures APPLICANT
First 20 ADDRESS
Additional
CITY Tel No
PERMIT
Fixed Appliances Not Over 1 HP APPLICANT �. DIIAl
Range Heater_ D W ADDRESS
Oven Dryer W M '
Top FAU W H CITY7,1/,4 e Tel No —
sc
Hood Fan REG NNUMBER Class p
Disp A C C.1
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY Q
Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING F—
Size&Type HP KW KVA or KVAR ELECTRICAL WIRING V
W
0-
Up to 1 Incl N
P I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
Over 1 to 10 Incl LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR Tl THAT 1 AM THE LEGAL OW R OF THE ABOVE
Over 10 to 50 Incl DESCRIBED RESI0,P L PROPERTY
A
Over 50 to 100 Incl PERMITEE _y 1G/Y
Over 100 SIGNATURE
Services DISTRICT NOS^ P SED BY
0 200 Amp Under 600 V
J' e" e
201 1000 Amp Under 600 V tNOTES
PPROVALS DATE IN ECTUR S
Over 1000 Amp or Over 600 V
SIGNATURE
POWER POLE
Temp Power Pole&Appurtenances SLAB WORK
Sign with One Branch Circuit
CONDUIT
Additional Sign Branch Circuits
(Other) 7
RES
AUTHORIZED
PERMIT FEE (Sub Total) YCO NOTIFIED
PLAN CHECKING FEE (One Fourth Permit Fee) Z' ►�..{
PERMIT ISSUING FEE
TOTAL FEE �
PLAN CHECK VALIDATION CK 1 MO CASH PERMIT VALIDATION K MO CASH
1
497rE'N0V 2y 2 D 650
? ) p1 1