HomeMy Public PortalAbout5414 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
CROSS ST.
Residential Swimming Pools 25.00 OWNER OR
FIRM NAME
Outlets: Rec Light Sw. MAIL
First 20 .50 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 1 REG. NUMBER Class.
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPUCA-
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
2.SO REGULATING ELECTRICAL WIRING. U
Up to 1 Incl. 1HEREBY CERTIFY THAT I AM PROPERLY REGISTV-RED AND/OR W
Over 1 to 10 Incl. 5.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF J
12.50 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
Over 1 0 to SO Incl. 25.00 DESCRIBED RESIDENTIAL PROPERTY.
Over 50 to 100 Inc.
Over 100 40.00 PERMITEE
SIGNATURE O
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Services DISTRICT NO. PROCESSED BY
0- 200 Amp.Under 600 V 1 2.50 W
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
Additional Sign Branch Circuits 2.00 INSPECTION >
l o.00 INFORMATION
Misc.Conduits&Conductors ON REVERSE i
Other(See Complete Fee Schedule) SIDE v
Z
Q _
J
CL
PERMIT FEE (Sub-Totals
PLAN CHECKING FEE (One-Fourth Permit Fee) O
PERMIT ISSUING FEE $7.00 0
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TOTAL FEE >
INSPECTION FINALED
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date: By