HomeMy Public PortalAbout8854 HERMOSA DR_Electrical__ 76A663 CE-806 NF 6/76 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN JOB
New Rfff.��iii���dential Bldgs.&P f� EACH NO. FEE ADDRESS 8854/8856 Hermosa Ave.
1 /Fomily,.Sq.Fr. 104 $ — 8 LOCALITY TemDleCit
Mu ti-family Sq. Fr. — NEAREST
CROSS ST. Rosemead
Residential Swimming Pools OWNEROR
FIRMNAME J. R. Miller
Outlets:Rec—Light_Sw._ MAIL 6924 Henrilee St.
First 20 ADDRESS
Total No. Additional CITY Lakewood Tel.No421-6801
A PILICANTK
Lighting Fixtures First 20 ADDRESS
Total No. Additional CITY Tel.No.
Fixed Appliances Not Over I HP PERMIT
Range_Heater_D.W. — APPLICANT Frank s Electric Co.
Oven—Dryer_W.M.— ADDRESS 4623 Durfee Ave.
Top _FAU _ W.H.— CITY Pico Rivera Tel.No699-4173
Hood_Fan _Other_ LICENSE OR
Disp._Room Air Cond. — REG.NUMBER 86190 Closs.Clo
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA-
Power Apparatus&Large Appl ionces TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO
Size&Type HP, KW, KVA,or KVAR COMPLY WITH
ELECTRICAL WIT ALL ORDINANCES AND STATE LAWS
REGULATINGUp to 1 Incl. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR O
Over I to 101ncl. LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF V
Over 10 to 501ncl. CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE cc
DESCRIBED RESIDENTIA OPERTY. Q
Over 50 to 100 Inc. ��TLjI
Over 100 PERMIT
EE
SIGNATURE N
Services DISTRICT NO. P ESS B. Z
0-200 Amp.Under 600 V �f
201 1000 Amp. Under 600 V
Over 1000 Amp.or Over 600 V Z .
7(p S�?/Z 73� O
Temp. Power Pole&Appurtenances
c ;5 5 9.9 A
Sign with One Branch Circuit
Additional Sign Branch CircuitsQ # o o'0 0 0 2
INSPECTION >
Misc.Conduits 8 Conductors INFORMATION Zoo 8 4,6 0
Other(See Complete Fee Schedule)_ ON REVERSE U 0 0 0 8 4,6 0 v
SIDE Z
tj 07201-79
PERMIT FEE (Sub Total) 77 6
Z
PLAN CHECKING FEE (One Fourth Permit Feel O
PERMIT ISSUING FEE 7 0 0
TOTAL FEE 84 .6 >
INSPECTION FINALED n
/� �1 W
date: / /,,,,�:�^,�'1–( By � ly ' Os