HomeMy Public PortalAbout5920 HART AVE_Electrical__ 76A663C- CE806B 12/75 UQU U UM ll 0- FOR LSLLSCUMCK LSLIUM
ILDING-A SAFETY DIVISION
FOR APPLICANT TO FILL IN - .JOB
New Residential Bldgs.&Pools
EACH NO. FEE ADDRESS b
1 &2 Finaily Sq. Ft. $ — $ LOCALITY
Multi-family Sq. Ft. — NEAREST. -
CROSS ST
Residential Swimming Pools OWNER OR
FIRM NAME
Outlets: Light,Switch & Receptacle MAI L
ADDRESS
First 20
Additional 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.VV.
ADDRESS
Oven Dryer VV.M.
Top _ FAU W.H. CITY el.
Hood Fan LICENSE OR a
REG. NUMBER Clas v O
Disp. A.C. v
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY O
Power Apparatus& Large Appliances WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING I_
ELECTRICAL WIRING. r..7
Size&Type HP, KW, K VA,or KVAR LLI
Up to 1 Incl. HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED ANO/OR z
Over 1 to 10 Incl. LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
_ CALIFORNIA OR THAT I AM THE E AL OWNER OF THE ABOVE
Over 10 to 50 Incl. DESCRIBED RESIOEN P O ER Y.
Over 50 to 100 Incl. PERMITEE
Over 100 SIGN ATUR
DISTRICT NO. P ES D BY
Services U
! 0-200 Amp. Under 600 V D
201 - 1000 Amp. Under 600 VAPPROVALS DATE INSP CTOR'S
Over 1000 Amp.or Over 600 V Over
TEMP. POWER POLE
Temp. Power Pole&Appurtenances UNDERSLAB WORK
Sign with One Branch Circuit
ROUGH CONDUIT
Additional Sign Branch Circuits
(Other) WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FEE (Sub-Total) UTILITY CO.NOTIFIED �y
PLAN CHECKING FEE (One-Fourth Permit Fee) FINAL ®6'' 7,y �s �
PERMIT ISSUING FEE
NOTES
TOTAL FEE !� ...
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. ASH
6 210[_-DEG 12 2 D 9. U �