HomeMy Public PortalAbout5956 GOLDEN WEST AVE_Electrical__ 76A663'ZE60b-1.1-71 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
OUTLETS NO EACH FEE
$ $ OWNER
RECEPT._ MAIL
ADDRESS /►�
LIGHT TOTAL FIRST 20 25 CITY TEL. NO 26319
SWITCH OVER 20 1p
PLAN CHECK
LIGHTING FIRST 20 25 APPLICANT
TOTAL
OVER 20 ADDRESS
FIXTURES 10
RESIDENTIAL APPLIANCES CITY TEL. NO.
PERMIT
RANGE DRYER_WTR HTR. APPLICANT
STA. COOK DISP. F.A.0 ADDRESS,
SPACE HTR AIR COND. CITY TEL. NO.
CLOTHES WASH DISHWASH. LICENSE NO. CLASS.
FAN OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND HEATERS, ETC HP KW KVA ELECTRICAL WIRING
SIZE & TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 - 1 100 LICENSEDAS REOUIRED BY LOS ANGELES COUNTY AND STATE OF a
_ CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
1 - 10 300 RESIDE IN, THE A VE DESCRIBED RE ENTIAL PROPERTY OU
10 - 50 500 SIGNATURE ^ �,
OF PERMITTEE O
50 - 100 1000 C
DISTRICT NO CLASS Z P CES9E
100 - 500 15 00 y
a
SIGN, GAS SIGN AND ONE CIRCUIT 500 NOTES: ?
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 100
SERVICENOTOVER 600 VOLTS OR 200AMP 300
APPROVALS DATE INSPECTOR'S SIGNATURE
SERVICEOVER 600 VOLTS OR 200AMP 1000
TEMP.POWER POLE
TEMP SERVICE,POLE, &APPURTENANCES 500
UNDERSLAB WORK
TEMP LIGHT OR RECEPT SYSTEM 300
ROUGH CONDI UT
WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FEE (SUB TOTAL)
UTILITY CO. NOTIFIED
PLAN CHECK FEE
7
PERMIT ISSUING FEE 300 3 G O FINAL ,
TOTAL FEE &<9
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALID TI NcK M o CASH
CQ
:LALo7395i:3 AUG S 2 D 6.00~
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
R
a