HomeMy Public PortalAbout10671 FREER ST_Electrical__ "76A 663=C E806 3-69
APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING , }
BUILDING AND SAFETY DIVISION ADDRESS m
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST 7
CROSS ST.
NO. EACH FEE
$ $ OWNER
RECEIPT._ MAIL � �/
LIGHT TOTAL FIRST 20 .20 ADDRESS
Z.CITY <r TEL.NO.
SWITCH OVER 20 .10 PLAN CHECK
LIGHTING TOTAL �tl
RST 20 ,20 APPLICANT
FIXTURES } ER20 ,10 -ADDRESS
RANGE_DRYER_WTR. HTR. CITY TEL.NO.
STA. COOK DISK. F.A.U. CONTRACTOR
SPACE HTR. AIR COND. ADDRESS
CLOTHES WASH. DISHWASH. CITY TEL.N0.
FAN OTHER 1.00 LICENSE NO. CLASS.
MOTORS,TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
IND. HEATERS, ETC. HP. KW. KVA. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
O - 1 1.00 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATEOF
1 - 10 3.00 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO Cl-
RESIDE IN, THE ABOVE DESCRIBED RESID TIAL OPERTY. O
10 - 50 5.00 U
SIGNATURE
50 - 100 10.00 OF PERMITTEE O
F-
100 - 500 15.00 D/IS�TRICT NO. GRO ZON PR CE W
SIGN ,GAS SIGN AND ONE CIRCUIT 3.00 `--�_/�- O N
TUBE, OR Z
MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES:
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00
SERVICE OVER 600 VOLTS OR 200 AMP 5.00
TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP. POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
WIRING
PERMIT FEE (SUB TOTAL) FIXTURES
PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED
PERMIT ISSUING FEE 2.00 /�}'� UTILITY CO.NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL
TOTAL FEE JOSEPH C. ROOHAN
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
I Ar2 4 1.5WT27 2 a 4.00-
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE -