HomeMy Public PortalAbout5406 GOLDEN WEST AVE_Electrical__ 76A663 CE 806(6/78)
APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN .JOB
FAppl
sidential Bldgs.&Pools EACH NO FEE ADDRESS
-Family,Sq. Ft. $ .025 — $ LOCALITY
-family Sq. Ft. .02 — NEAREST
25.00 CROSS ST.
ential Swimming Pools OWNER OR
FIRM NAME
Rec Light Sw. MAIL
First 20 50 ADDRESS
TotalNo. Additional 30 CITY Tel. No,
PLAN CHECK
APPLICANT
Fixtures First 20 .50 ADDRESS
Additional .30
No. CITY Tel. No.
ppliances Not Over 1 HP PERMIT
e,._Heater_D.W. APPLICANT
,Dryer_W.M.
ADDRESS
Top _FAU _ W.H. _ CITY Tel. No.
Hood,Fan —Other LICENSE OR
Disp._Room Air Cond, 2.50 REG,NUMBER Class,
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA.
Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO Off.
Size&Type HP, KW, KVA,or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING ELECTRICAL WIRING. U
2.50
Up to 1 Incl. 5.00 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LU
Over 1 to 10 Incl. LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
Over 10 to 50 Incl. 12.50 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
Over 50 to 1 00 Inc.
25.00 DESCRIBED RESIDENTIAL PROPERTY.
Over 100 40.00 PERMITEE
SIGNATURE O
Services 0
0- 200 Amp.Under 600 V
12.50 DISTRICT NO. PROCESSED BY W
201-1000 Amp. Under 600 V 25.00
Over 1000 Amp.or Over 600 V 50.00 Z
O
Temp. Power Pole&Appurtenances 10.00 Q
Sign with One Branch Circuit 10.00 G
Additional Sign Branch Circuits 2.00 INSPECTION >
INFORMATION
Misc.Conduits&Conductorsv
10.0o ON REVERSE _
Other(See Complete Fee Schedule) SIDE u
Z
Q
PERMIT FEE (Sub-Total
PLAN CHECKING FEE (One-Fourth Permit Feei 01
PERMIT ISSUING FEE $7.00 0
J
Q
TOTAL FEE >
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INSPECTION FINALED _
date: %�J/C/� BY / �,�)s��l/ /� � t ' ' 'vis