HomeMy Public PortalAbout4927 GLICKMAN AVE_Electrical__ 76g663-CE806 10/72 APPLICATIC� ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER JOB i
BUILDING AND SAFETY DIVISION ADDRESS
LOCALITY ''� ,ONEAREST '
FOR APPLICANT TO FILL IN CROSS ST.
OUTLETS NO. EACH FEE OWNER OR J
5 S FIRM NAME
RECEPT.� _ MAIL J
4-51 FIRST 20ADDRESS
LIGHT fQTA'L Q 6
CITY e TEL. N
SWITCH _ OVER 20 1p
PLAN CHECK
LIGHTING
FIRST 20 ZM 2-6
APPLICANT
T TAL
FIXTURES
OVER 20 .10 ADDRESS -
RESIDENT AL APPLIANCES CITY TEL. NO,
PERMIT
RANGE DRYER '/
WTR. HTR. APPLICANT
STA. COOK DISP. (/ F.A.U. ADDRESS
SPACE HTR, AIR COND. CITY T O�•�
CLOTHES WASH. DISHWASH. - LICENSE OR
REG. NUMBER CLASS.
FAN OTHER 1.00 _15VI HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS., TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING.
SIZE & TYPE OVER TO
' I HEREBY CERTIFY THAT I AM PROPERLY EG.ISTERED AND/OR
0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES C NTY NO STATE OF
CALIFORNIA OR THAI I AM THE LEGAL O {JER F THE ABOVE
IIESCR[RED RESIDENTI L PROPERTY. per„
1 - 10 3.00 O
PERMITEE v
10 — 50 5.00 SIGNATURE L�G�
O
50 — 100 10.00 DISTRICT N0. OC�SED B . U
LLL
100 — 500 15.00 00
N
Z
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTO SSIGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE
SERVI CENOTOVER 600 VOLTS OR 200 AMP / 3.00 UNDERSLAB WORK
SERVICEOVER600 VOLTS OR200AMP 10.00 ROUGH CONDUIT �]
TEMPSERVICE,POLE, &APPURTENANCES 5.00 WIRING ��� �: �•__``
TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES
POWER AUTHORIZED _,�'7K
UTILITY CO. NOTIFIED
' FINAL
PERMIT FEE (SUB TOTAL) NOTES:
PLAN CHECK FEE
PERMIT E
UING FEE 3.00
TOTALE
1 PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION EK. M.O. CASH
l
12 4��+n ly 2 2 7.5 5 ;
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE _
7GA663C- CE~B 12/75 APPLICATION FOR ELECTRICAL PERMIT
J
BUILDING AN AFETY DIVISI N
FOR APPLICANT TO FILL IN JOB r/
FResi'dential
Bldgs.& Pools EACH NO. FEE ADDRESS 8 ec /L;• �I
Sq. Ft. $ — $ LOCALITY
q. Ft. — NEAREST
imming Pools CROSS ST.
WNER OR
FG RM NAME
Outlets: Light,Switch& Receptacle / ADDRESS - Z
IL
First 20 r
Additibnal, CITYr ( Tel. NO.
PLAN CHECK-7 �7 f�
Lighting Fixtures APPLICANT f / r �/ ✓�C
First 20 ADDRESS/
Additional
CIT � T.I.
PERMIT
Fixed Appliances Not Over 1 HP APPLICANT
Range_ Heater L_ D.W.
ADDRESS
Oven Dryer W.M. `
Top FAU W.H. CITY YT L'IVo.
Hood Fan LICSE OR
REGE.NNUMBER Class. p
Disp. A.C. C.�
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY Q
Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING V
ELECTRICAL WIRING. W
Size&Type HP, KW, KVA,or KVAR
d
Up to 1 Incl. I HEREBY CERTIFY THAT 1 AMPRRTY
GISTERED AND/OR
Over 1 tO 1O Inci. LI CENSEO AS REQUIRED BY LOS ANAND STATE OFCALIFORNIA OR THAT 1 AM THE LER OF THE ABOVE
Over 10 to 50 Incl. DESCRIBED RESID EN PROPERTY.
Over 50 to 100 Incl. PERMITEE
Over 100 SIGNATURE 'ea"I
DISTRICT NO. P`ROC SSED BY
Services �c D� •� 1
0-200 Amp. Under 600 V
201 -1000 Amp. Under 600 V APPROVALS DATE IN•SPECTOR'S
Over 1000 Amp.or Over 600 V SIGNATURE
TEMP. POWER POLE
Temp. Power Pole&Appurtenances UNDERSLAB WORK
Sign with One Branch Circuit
Additional Sign Branch Circuits ROUGH CONDUIT
(Other) WIRING Irl )' � �fday
FIXTURES
POWER AUTHORIZED
PERMIT FEE (Sub-Total) UTILITY CO.NOTIFIED
PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL
PERMIT ISSUING FEE
NOTES
TOTALFEE P /
i
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
3 3 0r"-'SEP 24 2 1) 1 1.2 0