HomeMy Public PortalAbout5417 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
FResidentiall Bldgs.&Pools EACH NO FEE ADDRESS
,Sq. Ft. $ .025 — $ LOCALITY
Sq. Ft. .02 — NEAREST
25.00 CROSS ST.
wimming Pools OWNER OR
FIRM NAME
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 REG.NUMBER Class,
' HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA-
Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO a
Size&Type HP, KW, KVA,or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING ELECTRICAL WIRING. (,
Up to 1 Incl. 2.50 W
5.00 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR J
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
25.00 DESCRIBED RESIDENTIAL PROPERTY.
Over 50 to 100 Inc. cc
EE cc
Over 100 40.00 SIGNPERMATURE U
SIGNRE O
Services to
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
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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&Conductors
10.00 ON REVERSE i
Other(See Complete Fee Schedule) SIDE
Z
Q
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d
PERMIT FEE (Sub-Total,
PLAN CHECKING FEE (One-Fourth Permit Feei O
PERMIT ISSUING FEE $7.00 0
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TOTAL FEE >
t
INSPECTION FINALED
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date: �� � // a. ,P,S