HomeMy Public PortalAbout5435 GOLDEN WEST AVE_Electrical__ 76A663 CE-80616/78) 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 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&T e HP, KW, KVA,or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS C
yp REGULATING ELECTRICAL WIRING. U
Up 2.50 LU
U to 1 Incl. 5.00 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
Over 1 to 10 InclED 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 100 Inc.
25.00 DESCRIBED RESIDENTIAL PROPERTY.
Over 100 40.00 PERMITEE
SIGNATURE C
Services
DISTRICT NO. PROCESSED BY
0- 200 Amp. Under 600 V 12.50
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 C
Additional Sign Branch Circuits 2.00 INSPECTION >
Misc.Conduits&Conductors 10.00 INFORMATION u
ON REVERSE i
Other(See Complete Fee Schedule) SIDE v
Z
Q
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PERMIT FEE ISub-Totals a
PLAN CHECKING FEE IOne-Fourth Permit Fee) O
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PERMIT ISSUING FEE $7.00 0
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TOTAL FEE >
INSPECTION FINALED
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