HomeMy Public PortalAbout6021 HART AVE_Electrical__ APPLICATION
pp ®'®' q®{� � ggnm g�v�yy pp��g/�_ PERMIT
(Nom Ip��
,DBS-5A 3.55
DIVISION.OF BUILDING AND SAFETY "
Depoxtment of County Engineer
County of Los Angeles F=AbbRE�� °
WM.•J. FOX, COUNTY ENGINEER
CASSATT D. GRIFFIN. SUP'T OF BUILDING
OCALITY
FOR APPLICANT TO FILL IN NEAREST
PERMITTEES CROSS ST.
( NUMBER EACH. FEE
LIGHT OUTLETS I OWNER
RECEPTACLES - MAIL, '
ADDRESS
WALL SWITCHES -
TOTAL OUTLETS CITY TEL.
ELEC.RANGES 25. ELECTRIC( N A
_ELEC. HEATERS I/ - 25 ADDRESS
KW EA CITY
FIXTURES 5 411WLICENSE
NUMBER OF LIGHT CIRCUITS - DISTRICT Ui>r GROUP N I
NUMBER OF RECEPTACLE CIRCUITS READY FOR INSPECTION�� � I lf� .
MOTORS
NUMBER HORSEPOWER FEE - INSPECTION RECORD
NEW MVD. I HP ` OVER INC. y EACH
1/Z&LESS $ .25 /
1/z 2 .50 -
_ .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: q
WIRING $1:00
FIXTURES $1.001 ® '
SUPPLEMENTARY - -.50 APPROVALS '
TOTAL FEE Js o��� DATE INSPECTOR'S SIG�/NATURE
I HEREBY ACKNOWLEDGE THAT I HAVE' READ THIS APPLICATION CONDUIT. 2- ,(-e /1V;04,7_ -( J,/
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING J"eS`SJ f - �'dPit _
ELECTRICAL WIRING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT'I AM THE EGAL -OWNER OF THE ABOVE POWER
DESCRIBED RESIDENTIAL•PROPERT
* UTILITY CO.NOTIFIED
SIGNATURE �'�JI{ .,
10
OF PERMITTEE 4 is FINAL
WILLIAM J. FOX, COUNTY ENGINEER VALIDATION A. C.VEIT.CHIEF ELECT. INSPECTOR
-COO 0 0 4 n NOV 5 1 I �9-