HomeMy Public PortalAbout4938 HALLOWELL AVE_Electrical__ 76A663C- FES06B 12175 APPLICAT N FOR ELECTRICAL PERMIT
BUILDING A D SAFETY DIVISION
FOR APPLICANT TO FILL IN JOB rI ��
/�.� EACH NO. FEE ADDRES !'7/ �1, �-�
FRe ntial Bldgs.& Poo / �9
aily Sq. Ft. $ — $ LOCALITY (/,
ily Sq. Ft. — NEAREST •�' nCROSSST. ��al Swimming Pools OWNER OR
FIRM NAME �/�pht,Switch & Receptacle MAI LADDRESS
al CITY Tel. No.
PLAN CHECK
APPLICANT
Lighting Fixtures
First 20 ADDRESS
Additional CITY Tel. No.
PERMIT
Fixed Appliances Not Over 1 HP APPLICANT
Range Heater_ D.W.
ADDRESS [�
Oven Dryer W.M.
Top FAU W.H. CITY E� Tel. No sL/��
Hood Fan LICENSE OR / O
REG. NUMBER / 1 If Class. C-D
Disp., A.C:
1 HEREBY ACKNOWLEDGE THAT I HAVE READ TM 15 APPLICATION Q
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY V
Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING LaJ
Size&Type HP, KW, KVA,or KVAR ELECTRICAL WIRING. LL
cn
Up to 1 Incl. 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
Over 1•to 1O Incl. LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGA OWNER OF THE ABOVE
Over 10 to 50 Incl. DESCRIBED RE ENTIAL PRO PERTY.
-Over 50 to 100 Incl. PERMITEE
Over 100 SIGNATURE
DISTRIC O P CES ED BY
Services L^ Q - �r
0-200 Amp. Under 600 V J f�
201 - 1000 Amp. Under 600 V APPROVALS DATE INSP CTOR'S
SI NATURE"
Over 1000 Amp, or Over 600 V
TEMP. POWER POLE
Temp. Power Pole&Appurtenances UNDERSLAB WORK
Sign with One Branch Circuit
Additional Sign Branch Circuits ROUGH CONDUIT
(Other) WIRING .
FIXTURES 0
POWER AUTHORIZED
PERMIT FEE (Sub-Total) UTILI O.4NOTIFIE'D
PLAN CHECKING FEE (One-Fourth Permit Feel FINAL t4 •-
PERMIT ISSUING FEE
NOTES -
TOTAL.FEE ril Q
u 5?1 0. 0 0 (D
PLAN CHECK VALIDATION CK. M.O CASH RERMgT VALIDATWN CK. M.O. CASH -
0
ASH -o —+
. P Po po o g
J 0 .
O O O IV
CH •