HomeMy Public PortalAbout5441 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
FResidennaiBldgs.ential Bldgs.&Pools EACH NO. FEE ADDRESS
amily,Sq. Ft. $ 025 — $ LOCALITY
amily Sq. Ft. .02 — NEAREST
25.00 CROSS ST.
tial Swimming Pools OWNEROR
FIRM NAME
ec Light Sw. MAIL
First 20 .50 ADDRESS
o. Additional 30 CITY Tel. NaPLAN CHECK
APPLICANT
ixtures First 20 .50 ADDRESS
Additionalo. 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 a
Size&Type HP, KW, KVA,or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
yp REGULATING ELECTRICAL WIRING. U
2.50
Up to 1 Incl. 5.00 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR �
Over 1 to 10 In . LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF L6
Over 10 to 50 Incl. 12.50 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
2500 DESCRIBED RESIDENTIAL PROPERTY.
Over 50 to 100 Inc. . g
40.00 PERMITEE
Over 100 SIGNATURE O
Services a
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
Additional Sign Branch Circuits 2'00 INSPECTION >
INFORMATION
Misc.Conduits&Conductors 10.00 ON REVERSE _
Other ISee Complete Fee Schedule) SIDE U
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PERMIT FEE (Sub-Total
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PLAN CHECKING FEE (One-Fourth Permit Fee, O
PERMIT ISSUING FEE $7.00 0
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TOTAL FEE >
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INSPECTION FINALEDLU
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date: By ���� / a p
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