HomeMy Public PortalAbout4857 GLICKMAN AVE_Electrical__ 76A663 C6 806R 10,77 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER JOB �s L/, F7��
BUILDING AND SAFETY DIVISION ADDRESS y'D °!" 7 �> v 1 s;
FOR APPLICANT TO FILL IN LOCALITY ,%
New Residential Bldgs.&Pools EACH NO. FEE NEAREST
1 &2-Famil S Ft. $ .025 — $ CROSSST.
Family q' OWNER OR �!
Multi-family Sq. Ft. .02 — FIRM NAME
Residential Swimming Pools 25.00 MAIL
ADDRESS
Outlets:Rec Light Sw. CITY, r �f Tel.No.tit14,5-
First 20 .50 PLAN CHECK
Total No. Additional .30 APPLICANT
ADDRESS
Lighting Fixtures First 20 .50 CITY Tel.No.
Additional .30 PERMIT
Total No. APPLICANT
Fixed Appliances Not Over 1 HP ADDRESS
Range_Heater_D.W._ CITY Tel.No.
Oven_Dryer—W.M. LICENSE OR
Top —FAU —W.H.— REG.NUMBER Class.
Hood-Fan —Other— I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
Disp. _ Room Air Cond. 2'50 THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDIN-
ANCES AND STATE LAWS REGULATING ELECTRICAL WIRING.
Power Apparatus&Large Appliances
Size&Type HP, KW, KVA,or KVAR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM >_Up to 1 Incl. 2.50 THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY..
Over 1 to 101ncl. 5.00
Over 10 to 50 Incl. 12.50 PERMITTEE / �� � CD
Over 50 to 100 Inc. 25.00 SIGNATURE
Over 100 40.00 tR
STRICT NO. ED ti
Services / �� �`
0-200 Amp.Under 600 V 12.50 '� i' INSPECTOR'S
201-1000 Amp.Under 600 V25.00 APPROVALS D E SIGNATURE
Over 1000 Amp.or Over 600 V 50.00 MP.POWER POLETemp. Power Pole&Appurtenances10.00 DERSLAB WORKSign with One Branch Circuit 10.00 UGH CONDUIT
Additional Sign Branch Circuits 2.00 WIRING
A J
Misc.Conduits&Conductors 10.00 FIXTURES f
Other(See Complete Fee Schedule' POWERAUTHORIZED
UTILITY CO.NOTIFIED
FINAL
PERMIT FEE (Sub-Total) �% NOTES
PLAN CHECKING FEE (One-Fourth Permit Feel
PERMIT ISSUING FEE $7.00
TOTAL FEE ;71L
PL'AN,CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE r