HomeMy Public PortalAbout4939 HELEO AVE_Electrical__ 76A663 CE 806R 10/77 APPLICATION FOR ELECTRICAL PERMIT a B/.�
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER JOB
JC
ADDRESS eO
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN LOCALITY re,
/ — C
New Residential Bldgs.&Pools $EACH
25 NO. $ FEE NEAREST
CROSS ST./V l.Q •([J(_. s
1 &2-Family,Sq. Ft. OWNER OR
Multi-family Sq. Ft. 02 — FIRM NAME 4
Residential Swimming Pools 25.00 AMAIL
DDRESS % e.
Outlets: Rec Light_Sw. CITY 7; Tel.No.
First,20 .50 PLAN CHECK
Total No. Additional .30 APPLICANT
ADDRESS
Lighting Fixtures First 20 .50 CITY Tel. No.
Additional 30 PERMIT G
Total No. APPLICANT
Fixed Appliances Not Over 1 HP ADDRESS L
Range_Heater_D.W. CITY X/ <Mli IJA Tel. No.Df-37,03
Oven _Dryer W.M._ LICENSE OR
Top —FAU —W.H.— REG.NUMBER L Class.Gto
Hood—Fan _Other— I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
Disp. — Room Air Cond. 2.50 THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDIN.
ANCES AND STATE LAWS REGULATING ELECTRICAL WIRING.
Power Apparatus&Large Appliances
Size&Type HP, KW, KVA,or KVAR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM
Up to 1 Incl. 2.50 THE LEGAL OWNER OF THE ABOVE DESCRI ESIDENTIAL PROPERTY. C
Over 1 to 10 Ind.
5.00 v
Over 10 to 50 Incl. 12.50 PERMITTEE C- O
Over 50 to 100 Inc.
25.00 SIGNATURE
Over 100 40.00 DISTRI T NO. PR S N
Services
0- 200-Amp. Under 600 V 12.50 INSPE S
25.00 APPROVALS DATE SIGNA RE
201-1000 Amp,Under 600 V
Over 1000 Amp.or Over 600 V 50.00 TEMP. POWER POLE
Temp. Power Pole&Appurtenances
10.00 UNDERSLAB WORK
Sign with One Branch Circuit 10.00 ROUGH CONDUIT
Additional Sign Branch Circuits 2.00 WIRING
Misc.Conduits&Conductors 10.00 FIXTURES
Other(See Complete Fee Schedule) POWER AUTHORIZED
UTILITY CO.NOTIFIED 1
FINAL -16 ..
PERMIT FEE (Sub-Total)
J� NOTES 2!v/0Y.0H
{} 0 0 0 0 0 �.
PLAN CHECKING FEE (One-Fourth Permit Feel
1 0 0 �u, rJU
PERMIT ISSUING FEE $7.00 7
TOTAL FEE e .0 ° ° 24�5005
.
PLAN C CK LID N ! C M.0. CASH PERMIT VALIDATION CK. 0 M.693780A S H
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE