HomeMy Public PortalAbout5603 HALLOWELL AVE_Electrical__ DBS-5A 3;55 APPLICATION FOR ELECTRIC PERMIT
'DIVISION OF BUILDING AND SAFETY.
Department of County Engineer BUILDf
s County of Los Angeles ADDR EISS A /
WM.J. FOX. COUNTY ENGINEER
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• CASSATT D.GRIFFIN, SUPT OF BUILDING � �Jf � C'„�,�"'�j�
LOCALITY s�_ Ile,
FOR APPLICANT TO FILL IN NEAREST u G�
PERMIT FEES CROSS ST.
NUMBER EACH EACH FEE
OWNER
LIGHT OUTLETS
RECEPTACLES MAIL
ADDRESS
WALL SWITCHES
TOTAL OUTLETS !/r_ 5¢ CITY _ TEL.NO.A
ELECTRICIAN ' �
ELEC.RANGES � 25 -
� � -
ELEC. HEATERS 25 ADDRESS
KW EA CITY i" +`$.E;4�lJ Phi?cam' TEL.NO.
FIXTURES ) 5
NUMBER OF LIGHT CIRCUITS - DISTRICT NO. I GROUP Z I READY FOR INSPECTION
NUMBER OF RECEPTACLE CIRCUITS „y/ ;77
MOTORS q p11
NUMBER HORSEPOWERFEE �/ Js INSPECTION RECORD
NEW MVD. HP OVER INC. EACH f,•v
7j >'
7 LESS $ .25
2 .50 _ 6
2 5 1.00
5 15 1.50
15 50 2.50
50 200 . 5.00
misc.
NO.SIGNS NO.TRANS. '
NO.SIGNS NO.LAMPS
FOR EACH PERMIT:
WIRING $1.00 i
FIXTURES - $1.00
SUPPLEMENTARY .50 Y J� APPROVALS
TOTAL FEE s A�� DATE INSPECTOR'S SIGNATURE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS-AP 'KATION CONDUIT
AND STATE THAT THE ABOVE ICORRECT AND AGREE COMPLY
WITH ALL COUNTY ORDINANCEE S AND STATE LAWS REGULATING WIRING y
ELECTRICAL WIRING.
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF v
CALIFORNIA OR•THAT I AM,THE-LEGAL OWNER OF THE ABOVE POWER
DESCRIBED RESIDEN R-rY
SIGNATURE `C� //��' UTILITY CO.NOTIFIED n
�� i�!:� » "
OF PERMITTEE ( .
FINAL
WILLIAM J.FOX, COUNTY ENGINEER VALIDATION A.C.VEIT,CHIEF ELECT. INSPECTOR
LAC -e SOL DEC 14 2 _Z; 3.10 +� .