HomeMy Public PortalAbout10622 KEY WEST ST_Electrical__ 76;463-1E8@6 1 1-71 APPLICATION F R ELECTRICAL PERMIT LI
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING / ' J
BUILDING AND'SAFETY DIVISION ADDRESS d b Z [,tJ55=-r--
LOCALITY
�
LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
OUTLETS NO. EACH FEE p
OWNER J �T
RECEPT.� $ $ MAIL
FIRST 20 ADDRESS
LIGHT OVER 20 TOTAL 25 �
CITY EL. NO.
SWITCH _a_ ID PLAN CHECK
FIRST 20 APPLICANT
LIGHTING � TOTAL 25 ay � ,
FIXTURES
OVER 20 10 ADDRESS
RESIDENTIAIE APPLIANCES clrY TEL. No.
PERMI T P_
RANGE DRYERWTR. HTR. APPLICANT
STA. COOK DISP. F.A.U. ADDRESS
SPACE HTR, AIR COND. CITYTEL. NO.gZat
. c
CLOTHES WASH. - �DII,SHWASH. LICENSE N0. CLASS. .��L
FAN OTHER 641',A 100 f 00 1 HEREBY ACKNOWLEDGE'THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND. HEATERS, ETC. HP KW. KVA. ELECTRICAL WIRING.
SIZE & TYPE OVER TO -
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF }
CALIFORNIA OR THAT IAM HE LEGAL OWNER OF, AND INTEND TO O
1 - 10 300 RESIDE IN, THE ABO VE
SCRIBE RESIDENTI ALL PROPERTY.
U
10 - 50 500 SIGNATURE
OF PERMITTEE O
50 - 100 1000
DISTRICT NO. JCLASS ZO E PRO SED
d W
100 - 500 1500 Q h
SIGN, GAS =AND ONE CIRCUIT 500 NOTES: ?
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 100 -
SERVI CENOTOVER 600 VOLTS OR 200 AMP 3.00 J �d
APPROVALS DATE INSPECTOR'S SIGNATURE
S ERVI CE OVER 600 VOLTS OR 200 AM P 10.00
TEMP.POWER POLE
TEMP SERVICE,POLE, &APPURTENANCES 500
UNDERSLAB WORK
TEMP LIGHT OR RECEPT. SYSTEM 300
ROUGH CONDI UT
WIRING
FIXTURES 7-21- -74/
POWER AUTHORIZED -
PERMIT FEE (SUB TOTAL)
UTILITY CO. NOTIFIED 7_
PLAN CHECK FEE
FINAL ,•���, ��� �
PERMIT ISSUING FEE 300 ,3 d
TOTAL FEE J d O
PLAN CHECK VALIDATION CK M.0. CASH PERMIT VALIDATION cK. M.0. CASH
9 ?.-2'c`_lPMY :.14 2--D '1 2:0 0 &18
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department of County Engineer ELECTRIC
DIVISION OF BUILDING & SAFETY
WILLIAM J. FOX, County Engineer
FOR PL NTT F LL IN DISTRICT NO. GROUP ZONE PERMIT NO.
ELECTRIC[
RECEIVED BY READY FOR DATE ISSUED
ADDRESS FIRST INSPECTION
CITY
COUNTY LI EHSE NO. EXPIRES BUILDING
PERMIT FEE ' ADDRESS
NUMBER EACH FEE LOCALITY
LIGHT OUTLETS NEAREST
CR066 BT.
RECEPTACLES
WALL SWITCHES OWNER
TOTAL OUTLETS SC MAIL '
ELEC. RANGES 71 S5 ADDRESS
ELEC. HEATERS 25
CITY TEL NO.
FIXTURES B
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
M19C. APPLICATION AND STATE THAT THE ABOVE IB CORRECT
NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCEB
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING.
MOTORS [ CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB
NUMBER HORSEPOWERFEE ANGELES COUNTY LICENSE, OR AM THE LEGAL OWNER
NEw MVD. HP OVER INC. EACH OF THE REBIDENTIA PERTY DESC BE A VE.
%2 6 Leas S .25 SIGNATURE OF
%2 2 .50 PERMITTE
2 5 1.00 INSPECTION RECORD
5 is 1.50
15 so 2.50
50 200 S.00
200 500 10.00 J
Q
_ 500 1000 15.00 Z
OVER 1000 20.00 [�
M.G. SET/FREQ. CHANGER-HP R'
WELDERS:AC-KVA
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75% OF ORIG•)
MOVED MOTORS (75% OF ORIG.)
MISC.
SIGNS
NO. NO.TRANS.
APPROVALS
NO. NO. LAMPS
I
DATE INSPECTO 'S NAME
FOR EACH PERMIT:
WIRING $1.00 CONDUIT /A A n_
FIXTURES _ $1.00 ""�`- WIRING
SUPPLEMENTARY .50
FIXTURES
POWER hell) / Q j '/
TOTAL FEE !9 tf UTILITY CO.NOTIFIED —
FINAL
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