HomeMy Public PortalAbout6047 GOLDEN WEST AVE_Electrical__ '' .3 CE 8068 10/77 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER 4ADDRESS
OB
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN OCALITY t
New Residential Bldgs &Pools EACH NO
FEE
EAREST
1 &2-Family,Sq Ft $ 025 — $ CROSSST
OWNER OR
Multi-family Sq Ft 02 — FIRM NAME
Residential Swimming Pools 2500 MAIL
ADDRESS
Outlets ReitLight_Sw CITY Tel No f
First 20 50 PLAN CHECK
Total No Additional 30 APPLICANT
ADDRESS
Lighting Fixtures First 20 50 CITY ' Te o
Additional 30 PERMIT
Total No APPLICANT
Fixed Appliances Not Over 1 HP ADDRESS
RongeL Heater_D W CITY Tel No
Oven _Dryer—W M_ LICENSE OR
Top —FAU —W H REG NUMBER Class
Hood_Fan _Other— HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
Disp — Room Air Cond 2 50 O THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDIN
ANCES AND STATE LAWS REGULATING ELECTRICAL WIRING
Power Apparatus&Large Appliances
Size.&Type HP, KW, KVA,or KVAR I HEREBY'CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM ?�
Up to 1 Ind 2 50 THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY
Over 1 to 10 Incl 500 v
Over 10 to 50 In1 2 50 PERMITTEE
Over 50 to 100 Inc 2500
SIGNATURE
LI
Over 100 4000 TDISTRICT NO OCESSE ,�Y d
�. Z
Services 0 200 Amp Under 600 V 1250 /Z INSPECT R S
201 1000 Amp Under 600 V 2500 APPROVALS DATE SIGNATURE
Over 1000 Amp or Over 600 V 5000 MP POWER POLE
UNDERSLAB WORK,,,
Temp Power Pole&Appurtenances 1000
Sign with One Branch Circuit 1000 ROUGH CONDUIT
200 WIRINGA
Additional Sign Branch Circuits 4
Misc Conduits&Conductors 1000-
+ ,'
FIXTURES
Other(See Complete Fee Schedules POWER AUTHORIZED
e UTILITY CO NOTIFIED
a' FINAL
PERMIT FEE '(Sub Tbtoh-
� NOTES
PLAN CHECKING FEE (One Fourth Permit Feel
PERMIT•ISSUING FEE $7,00 Q
TOTAL FEE Z41+ O
PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION CK MO CASH
a s� '
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE ''