HomeMy Public PortalAbout5411 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
New Residential Bldgs.&Pools EACH NO. FEE ADDRESS
1 &2-Family,Sq. Ft. $ .025 — $ LOCALITY
Multi-family Sq. Ft. .02 — NEAREST
25.00 CROSS ST.
Residential Swimming Pools OWNER OR
FIRM NAME
Outlets:Rec Light Sw. MAIL
First 20 ADDRESS
Total No. Additional 30 CITY Tel. No.
PLAN CHECK
APPLICANT
Lighting Fixtures First 20 .50 ADDRESS
Additional 30
Total No. CITY Tel. No.
Fixed Appliances Not Over 1 HP PERMIT
Range_Heater_D.W.
APPLICANT
Oven—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.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA
Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO d
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 AM PROPERLY REGISTERED AND/OR
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
CL
Services
DISTRICT NO. PROCESSED BY
0-200 Amp. Under 600 V 12.50
F
201-1000 Amp. Under 600 V 25.00
Over 1000 Amp.or Over 600 V 50.00 Z
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Temp. Power Pole&Appurtenances 10.00 Q
Sign with One Branch Circuit 10.00 0
Additional Sign Branch Circuits 2.00 INSPECTION >
lo.00 INFORMATION W
Misc. Conduits&Conductors ON REVERSE x
Other ISee Complete Fee Schedule) SIDE U
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I. N
PERMIT FEE (Sub-Total)
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PLAN CHECKING FEE (One-Fourth Permit Fee) p
PERMIT ISSUING FEE $7.00 0
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TOTAL FEE >
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INSPECTION FINALED
date: ���� By