HomeMy Public PortalAbout4922 HELEO AVE_Electrical__ 76A663-CE806 3-69 `` ''
RMT
APPUCAMN FOR
tr�k r. ff.
69-7
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
• BUILDING AND SAFETY DIVISION BUILDING 2-� ,[
', ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER Ca
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY /
3. NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
NO. EACH FEE
$ $ OWNER
RECEIPT. MAIL
LIGHT_ TOTAL FIRST 20 "2 .2p CJo ADDRESS
SWITCH OVER 20 ,10 4c,
'CITY TEL.NO.
PLAN CHECK
LIGHTING TOTAL FIRST 20 ,20 J APPLICANT
FIXTURES [7OVER 20 •10 ADDRESS
RANGE_DRYER_WTR. HTR. CITY TEL.NO.
STA. COOK_DISP. F.A.U. CONTRACTOR
SPACE HTR..�AIR COND. ADDRESS.���
� -
CLOTHES CITY TEL.NO.
/WASH. DISHWASH. ✓� J �"�• �" �
FAN OTHER 1.00 LICENSE NO. 7 CLASS. C-1 U v
MOTORS,TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
IND. HEATERS, ETC. HP. KW. KVA.. AN DSTATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
O - 1 1.00 I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATEOF
1 - 10 3.00 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO d
RESIDE IN, THE ABOVEDESCR ED RESIDENTIAL PROPERTY. 0
10 - 50 5.00 V
SIGNATURE p�
50 - 100 10.00 OF PERMITTEE
100 - 500 15.00 ° DISTRICT NO.• .GROUP , PR CE D'BY .W
SIGN,GAS SIGN AND ONE CIRCUIT 3.00
.
TUBE, OR Z
MARQUEE ADDITIONAL CIRCUITS 1.00 �• NOTES:
SERV ICE NOT OVER 600 VOLTS OR 200 AMP 2.00 -�
SERVICE OVER 600 VOLTS OR 200 AMP 5.00
TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE .INSPECTOR'S SIGNATURE
TEMP. POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT if
L�
WIRING
PERMIT FEE (SUB TOTAL) FIXTURES
'.' PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED
PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL -17, �(,w.,/' ► ..:
TOTAL FEE ` 6"f JOSEPH C. ROOHAN
V SUPERVISING ELECTRICAL ENGINEER
mr
7 11
PLAN CHECK VALIDATION CK.I `
M.O. CASH PERMIT VALIDATION =" M.O. CASW
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE