HomeMy Public PortalAbout5716 GOLDEN WEST AVE_Electrical__ 76A663C- CE8068 112,75 APPLICATION FOR ELECTRICAL PERMIT 1
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN JOB
•ADDRESS/�6 LGcjj•L/ (C��-(/
FResidential Bidgs & Pools EACH NO FEE
Finaily Sq Ft. $ — $ LOCALITY
-family Sq,Ft — NEAREST 1
ential Swimming Pools CROSS ST
- OWNER ORFIRMNAME
Light, Switch& Receptacle MAI L
20 uyQADDRESS
tional CITY Tel• No
PLAN CHECK
g Fixtures APPLICANT
20 ADDRESS
tionalCITY Tel NoPERMIT
ppllarices Not Over 1 HP APPLICANT
Range Heater_-DW ADDRESS
,Oven Dryer W M.-ilisilift�
Top FAU W H CITY Tel No i
Hood Fan REG LICENSE
ER Class O
Dlsp A.C.'_
/ �� I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
' LLL AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY Q
Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING 1 ELECTRICAL WIRING -
Size&Type HP, KW,KVA,or KVAR ,? �
Up to 1 Incl 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR Z
Over 1 to 10 Incl LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
' CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
Over 10 to 50 Incl DESCRIBED REZITIAL PROPERTY
Over 50 to 100 Incl PERMITEE
Over 100 SIGNATURE
DISTRICT NO OCES BY )
Services
0-200 Amp. Under 600 V CJ
201 - 1000 Amp Under 600 V APPROVALS �f TE
INSPECTOR'S
Over 1000 Amp or'Over 600'V, SIGNATURE
TEMP OWER POLE
Temp Power Pole&Appurtenances UNDERSLAB WORK
Sign with One Branch Circuit
Additional Sign Branch Circuits ROUGH CONDUIT
(Other) - WIRING —I-
FIXTURES
POWER AUTHORIZED
PERMIT FEE (Sub-Total) UTILITYCO NOTIFIED
PLAN CHECKING FEE (One-Fourth Permit Fee)
FINAL
PERMIT ISSUING FEE
NOTES
TOTAL FEE f`
-
PLAN CHECK VALIDATION CK MID CASH PERMIT VALI , TION CK MO 'CASH-
&6