HomeMy Public PortalAbout10721 LA ROSA DR_Electrical__ •7en86a-cEeo6 1;TD APPLICATION FOR ELECTRICAL PERMIT
COUNTY.OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEERBUILDING /J
BUILDING AND SAFETY DIVISION ADDRESS ID 91 ,C 47
JOHN A. LAMBIE, COUNTY ENGINEER LOCALITY
COLEMAN W. JENKINS SUPERINTENDENT OF BUILDINGNEAREST
FOR APPLICANT TO FILL IN CROSS ST,
OUTLETS NO. EACH I
AA�� OWNER
RECEPi��a� S MAIL
LIGHT TOTAL FIRST 20 �.Q ADDRESS /07 /
n:) yy
CITY G4C , TEL. N0. yI/3,5`y
SWITCOVER 20 3 .10 PLAN CHECK
LIGHTING TOFIRST 20 20 APPLICANT
rTAL
FIXTURES l2i L OVER 20 10 ADDRESS
APPLIANCES CITY TEL, No.
PERMIT
RANGE_DRY ER_WTR. HTR._ APPLICANT (il/
STA. COOK_DISP._F.A.U.L ADDRESS �0`T z Q.
SPACE HTR. AIR GOND. CITY TEL, NO. �/y�3STer
CLOTHES WASH.—x—DI SHWASH._ LICENSE NO. CLASS.
FAN_OTHER. 1.00 O 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY
VA.MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANC E9 AND STATE LAWS REGULATING
IND. HEATERS, ETC. HP. KW. KELECTRICAL WIRING.
SIZE 6 TYPE OVER TO
HEREBY CERTIFY THAT AM PROPERLY REGISTERED AND/OR 1
O - I 1.00 LICENSED AS REQUIRED BT LOS ANGELES COUNTY AND STATE OF
CAL FO q NIA OR THAT AM THE LEGAL OWNER OF, INTEND TO
1 - 10 / 3.00 0 6 RESIDE IN, THE ABOVE DESCRIBED RESIDE I PR PERTY.
1 SIGNATURE 1
10 - 50 5.00 OF PERMITTEE O 0
50 — 100 10.00
D19TRICTgNOO. CLASS OROVP ZON RO 6`ED O
100 — 500 t100 c�(/ .� ° U
W
SIGN AND ONE CIRCUIT 3.00 NOTES:
SIGN, GAS
TUBE, OR Z
IF
MARQUEE ADDITIONAL CIRCUITS 1.00
SERVICE NOT OVER 600VOLTS OR200AMP I .00
APPROVALS DATE INSPECTOR'SSIGNATURE
SERVI CE OVER 600 VOLTS OR 200 AMP 5.00
TEMP.POWER POLE
TEMP SERVICE,POLE, &APPURTENANCES 3.00
UNDERSLAB WORK
TEMP LIGHT OR RECEPT. SYSTEM 3.00
ROUGH CON DIUT
WIRING
PERMIT FEE (SUB TOTAL) FIXTURES POWE
PLAN CHECK FEE (507, PERMIT FEE) /
UTILITY CO. NOTIFIED •Ql'/h I /I� n if
PERMIT ISSUING FEE /00
FINAL
SUPPLEMENTARY PERMIT ISSUING FEE
JO
4o SEPH C. RECT
TOTAHAN
L FEE SUPERVISING ELECT CAL ENGINEEP.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION cK. M.o. CASH
' ACfl2104 � 1. 2 D 21 .90- Q
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department of County Engineer �������
DIVISION OF BUILDING & SAFETY
WILLIAM 1. FOX, County Engineer
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT,,NOO.
ELECTRICIAN S. W HERRIN 5 -� b 2yD
—AS A RECEI,yED BY READY FOR DATE ISSUED
ADDRESS _ r 1�1 FIRST INSPECTION /' / J
CITY TEL NO. ��IW.•V/. LI/ 4 �„/`f
COUNTY LICENSE NO. Q EXPIRES J SUIL�/�7 9 ' /7 //A s
PERMIT FEES ADO REBS ¢[ Y� f+� 'FMR I
FEE ip i
NUMBER EACH LOCALITY L/
LIGHT OUTLETS A. NEAREST
RECEPTACLES GROSS ST.
WALL SWITCHES OWNER
TOTAL OUTLETS Sc 0 1 r MAIL 1
ELEC. RANGES 25 -Y— ADDRESS _
ELEC. HEATERS2S
CITY TEL. NO.
FIXTURES B
— I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
MISC. APPLICATION AND STATE THAT THE ABOVE IS CORRECT
NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS 1 AND STATE LAWS REGULATING ELECTRICAL WIRING.
MOTORS 1 CERTIFY THAT 1 POSSESS THE A0OVE VALID LOS
NUMBER MORSEPCWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
NEW MV.. HP .VER iNc. eAeM OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
I/2 6 LEER S .25 - SISNATURE OF
I/2 2 .5O PERMITTEE T'
2 5 1.00 INSPECTION RECORD
_ 5 10 1.50 _
_ 15 50 2.50
_ 50 200 5.00
_ 200 500 10.00 J
5001000 15.00 a
Z
OVER 1000 20.00
M.G. BET/FRED. CHANGER-HP d'
WELDERS: AC-KVA O
GENERATORS - KW _
TRANSFORMERS - KVA _
TEMP. MOTORS (75% OF ORI..)
MOVED MOTORS (75% or CRI..)
MISC.
SIGNS
NO. NO.TRANS. APPROVALS
N0. NO.LAMPS
FOR EACH PERMIT: DATE INSPECTOR'S NAME_
WIRING S1.O0 If CONDUIT
FIXTURES $1.00 WIRING
SUPPLEMENTARY .50 FIXTURES
OWER
TOTAL FEE ® .� UTILITY CO.NOTIFIED
/ FINALG-
76A663 DHS#5A 4-52 1