HomeMy Public PortalAbout9931 / 9227 GARIBALDI AVE_Electrical__ 76A663Cy- CE8068 12/75 APPLICATION FOR ELECTRICAL PERMIT
BUILDIN ND SAFETY ;�(SION
FOR APPLICANT TO FILL IN ,JO r-� /�
rResidentialal Bldgs.& Pools EACH O. FEE ADDRESS K/[/� D 11
Sq. Ft. _�� — $ �GI — $ LOCALITYQSq. Ft. — NEAREST 'CROSS ST. d L '+A. Dwimming Pools OWNERORFIRMNAME
, Switch&Receptacle MAI L e
ADDRESS ] C
First 20
Additional CITY Tel. No. / J
PLAN CHECK C
Lighting Fixtures APPLICANT J
First 20 ADDRESS
Additional
CITY Tel. No.
PERMIT
Fixed Appliances Not Over 1 HP APPLICANT
Range Heater_ D.W. ADDRESS
Oven Dryer W.M.
Top FAU W.H. CITY Tel. No.
Hood Fan LICENSE OR
REG. NUMBERJ066 5 Class. C.D
Disp. A.C.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION O
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY V
Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING LJ
Size&Type HP, KW, KVA,or KVAR ELECTRICAL WIRING, N
z
Up to 1 Incl. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
Over 1 to 10 Incl. LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL O R OF T ABOVE
Over 10 to 50 Incl. DESCRIBED RESIDE TIAL P OPERTY.
Over 50 to 100 InCI. PERMITE
Over 100 SIGNAT
DISTRICT NTD. PROCESSED BY
Services
0-200 Amp. Under 600 V
201 - 1000 Amp. Under 600 V APPROVALS DATE INSPECTOR'S
SIGNATURE
Over 1000 Amp.or Over 600 V
TEMP.POWER POLE
Temp. Power Pole&Appurtenances UNDERSLAB WORK
Sign with One Branch Circuit ROUGH CONDUIT
Additional Sign Branch Circuits C
(Other) WIRING
FIXTURES i
POWER AUTHORIZED /�
PERMIT FEE (Sub-Total) UTILITY CO.NOTIFIED
PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL
PERMIT ISSUING FEE '
TOTAL FEE NOTES
a I M.O. CASH PERMIT VALIDATION CK. M.O. CASH
9 3 l
ICY HOLDER:
CY NUMBER: