HomeMy Public PortalAbout5226 GOLDEN WEST AVE_Electrical__ 768663-CE806 a C;. APPLICATION FOR ELECTRICAL PERMIT �J
COUNTY OF LOS ANGELES
DEPARTMENTUILDING ER ADB
AND SAFETY DIVISION B 5' �0 �t) F�
ADDRESS L e4
LOCALITY 4mwoiiRT Te-i,►1Pie-
NEAREST
FOR APPLICANT TO FILL IN CROSS ST /j,
7RECEPT.3�6'�
TS OWNER OR
NO $EACH s FEE RM NAME (4��r' , I—' A Ce
MAIL
FIRST20 � 29 /) ADDRESSTOTAL vCITY . CTEL NO -j7jJf(� OVER 20 ip
PLAN CHECK
FIRST 20 25 S' /") APPLICANT :SL?�rv� cy.,.4""L,
LIGHTING TOTAL J V
OVER 20 ADDRESS
FIXTURES -3 10
RESIDENTIAL APPLIANCES CITY TEL NO
PERMIT
RANGE/DRYER—WTR. HTR APPLICANT
STA COOK DISP /F A U L ADDRESS
SPACE HTR. AIR COND CITY TEL NO
DISHWASH._L_ LICENSE OR CLASS.
CLOTHES WASH. REG. NUMBER
FANOTHER 100 I 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 1 AM PROPERLY RE TIERED AND/OR
0 — 1 100 LICENSED AS REQUIRED BY L ANG LES C Y AND STATE OF
CALIFORNIA OR THAI HE L AL NER OF THE ABOVE )..
1 — 10 300 DESCRIPED RESIDE A OPER O
PERMITEE U
10 - 50 500 SIGNATURE 0
H
50 - 100 1000 DISTRICT NO. P 0 SED BY IU
00 — 500 ,5 00 ,� z
SIGN, GAS SIGN AND ONE CIRCUIT 500 APPROVALS DATE INSPECTOR'S SIGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 100 TEMP POWER POLE
SERVICENOTOVER600VOLTS OR200AMP 300 QV UNDERSLAB WORK
SERVICEOVER600VOLTS OR200AMP 1000 ROUGH CONDUIT
TEMPSERVICE,POLE, &APPURTENANCES 500 WIRING
TEMP LIGHT OR RECEPT. SYSTEM 300 FIXTURES
POWER AUTHORIZED allV
UTILITY CO. NOTIFIED Y� `I 4A
FINALCI` • �����
PERMIT FEE (SUB TOTAL) NOTES
PLAN CHECK FEE 61,
PERMIT ISSUING FEE 300 O
TOTAL FEE
PLAN CHECK VALIDATION CK M 0 CASH MIT VALIDATION cKM 0 CASH
3 0 r�
{ �t'r34 ? �3 D0T 9 2 D 9
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE