HomeMy Public PortalAbout9217 GARIBALDI AVE_Electrical__ 75AO53-CESOO 11_41 APPLICATION FOR ELECTRICAL P lT
COUNTY OF LOB ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADORESS J
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CR038 ST.
OUTLETS NO, ILACH I FEE
OWNER
RECEPT._ MAIL
LIGHT TOTAL
FIRST 90 251 1. ADDRESS
SWITCH OVER 20 ip CITY TEL. NO.
- PLAN C ECK
LIGHTLNGTOTAL ' FIRST 20 25APPLICANT
FIXTURFS OVER 20 t0 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL. NO.
PERMIT
RANGE DRYER WTR. HTR.- APPLICANT ��
STA. COOK DISP. L F.A.V. ADDRESS
SPACE HTR. AIR CON D. - CITY TEL. NO&tW 7f
CLOTHES WASH.TDISHWASii. LICENSE 40.2 7� CLASS.
FAN OTHER 1.00 1 HERESY ACKNbWLEDSE THAT I HAVE TI[AD THIS APPLICATION
AND STATE THAT THE A/OVA 1/ CORRECT AND AGREE TO COMPLY
MOTOR/' TM11/FORM[R/ MTINS WIT+I ALL COUNTY ORDINANCE/ AND /TAT[ LAWS REbu LATINS
IND. HEATER/, ETG. HP. KW. RVA. ELECTRICAL WUt INS-.
SIZE S TYPK OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY RESISTERED AND/OR
0 — 1 t.00 _ LICE"ED
AS NEOUIREO BY LOS AN LES COUNTY AND STAT[ OF
/� CALIFORNIA OR THAT f AµTHE E NIR OP, AND INTEND TO
1 - 10 3Ap 00 RESIDE IN, THE A D RESIDE IAL PROPERTY.
SIGNATURE
10 - b0 600 OF PERMITTEE O
b0 =100 10.00
DI3TRICTNO. CLASS [ PRO fs[D Y
100 - 500 15-00 , _ n-
SIGN, GAS SIGN AND W
ONE QIRCT 500 NOTES;
TUBE,dR
MARQUEE_ ADDITIONAL CIRCUITS 1.00
SERVILENOTOVER600VOLTS OR2.00AMP 3.00 � d
JIPPMOVALi DAT[ �If!lIMIOR'S SIMUTUIt
$ERVICEOVER600VOLTSOR200AMP 70
TEMP.POWER POLE
TEMPS$RVICE,POLE,Q APPURTENANCES 4c
TEMP LIGHT OR RECEPT. SYSTEM 300 UNDPR8IAB WORK
ROUGH CONDIOT
WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FEE (SUB TOTAL)
UTH TY CO. NOTIFIED
PLAN CHECK FEE
FINAL
PERMIT ISSUING FEE s.00• �a
TOTAL FEE 0 Q
PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CK. M.O. CAST+
leo 2 7ki .fa 27 2 D 9..0 0-
SEE SACK OF APPLICATION FOR COMPLETE SCHEDULE '
\ ` COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department of County Engineer ELECTRIC
���'
DIVISION OF BUILDING & SAFETY
WILLIAM J. FOX, County Engineer
FOR APPLICANT TO FILL IN DISTRICT NO. ORDUE11, ZONE PERMIT NO.
ELECTRICIAN
s RECEI)/kid BY READY FOR DATJE ISSUED
ADDRESS FIRST INSPECTION a
CITY_ TEL.NO. `•
COUNTY LICENSE NO. EXPIRES BUILDING
PERMIT FEES ADDRESS
FEE
NUMBER EACH LOCALITY
LIGHT OUTLETS NEAREST
RECEPTACLES CROSS BT
WALL SWITCHES 7_ OWNEK '� '
TOTAL OUTLETS sir �I
5c $ MAIL
ELEC. RANGES 25 ADDRESS _
ELEC. HEATERS 25 7_ �.'. �, 220
CITY �'•� n. - TEL. N
FIXTURES ;o'� S
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
MISC. APPLICATION AND STATE THAT THE ABOVE IS CORRECT
NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING.
MOTORS 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
NUMBER _HORSEPOWER FEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL. OWNER
NEw MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIB D ABOOVE'�.
%2 & LESS $ .25 SIGNATURE OF
%2 R .50 PERMITTE ? C= '° ✓ _
2 5 1.0o INSPECTION RECORD
_ 5 is l.sD
15 s0 2.50
200 5.00
20D 500 10.00
500 1000 15.00 r
_Z
_ OVER 1000 _ 20.00 0
M.G. SET/FREQ. CHANGER-HP Of
0
WELDERS: AC-KVA
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75% OF CRIS•) _Y
MOVED MOTORS (75% OF ORIG.)
MISC.
SIGNS
NO. NO.TRANS.
APPROVALS
NO. N0. LAMPS
DATE INSPECTOR'S NAME
FOR EACH PERMIT: —
CONDUIT
_WIRING $1.170
FIXTURES $1.00 WIRING LT 1
SUPPLEMENTARY ,50 FIXTURES
POWER 1
TOTAL FEE $ G UTILITY CO.NOTIFIED
000LLL FINAL
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