HomeMy Public PortalAbout5671 LOMA AVE_Electrical__ 76A663-CE806 II/70 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN FOR
CROSS ST.
OUTLETS N0, EACH FEE
OWNER
S S _
RECEPT._ MAIL
LIGHT TOTAL
FIRST 20 25, ADDRES
CITY TEL. NO.
SWITCH OVER 20 .10
PLAN CHEC
LIGHTING TOTAL FIRST 20 25 APPLICANT
FIXTURES
OVER 20 .10 ADDRESS
APPLIANCES CITY TEL. NO.
PERMIT
RANGE DRYERWTR. HTR._ APPLICANT
STA. COOK DISP. F.A.U. ADDRESS /
SPACE HTR. AIR COND. CIT TEL. N0. 671
CLOTHES WASH. DISHWASH. �J LICENSE NO. J/� CLASS. C-/O
FAN OTHER 1.00 _/ /�./) I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
O(, V 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
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO >-
I - 10 3.00 RESIDE IN, THE A E DE CRI ED RESIDE NTIA PROPERTY, d
11 0
10 - 50 5.00 SIGNATURE CJ
OF PERMITTEE
50 - 100 10.000
DISTRICTNO. jCllk'SS ZONE y111SS ED BY V
100 - 500 15.00�� I �� Lu
SIGN, GAS=AND ONE CIRCUIT 5.00 NOTES: N
Z
TUBE, OR -
MARQUEE ADDITIONAL CIRCUITS 1.00
SERVICE NOT OVER 600 VOLTSOR200AMP 3.00 �
APPROVALS DATE INSPECTOR'S SIGNATURE
SERVI CE OVER 600 VOLTS OR 200 AMP 10.00
TEMP.POWER POLE
TEMP SERVICE,POLE, &APPURTENANCES 5.00
UNDERSLAB WORK
TEMP LIGHT OR RECEPT. SYSTEM 3.00
ROUGH CONDIUT
WIRING O
FIXTURE'S
PERMIT FEE (SUB TOTAL) POWER AUTHORIZED
UTILITY CO. NOTIFIED '
PLAN CHECK FEE
w FINAL
PERMIT ISSUING FEE 3.00 Ojl-
JOSE C. ROOHAN
TOTAL FEE SUPER I 1I G ErC)K
CAL ENGINEER,
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VAL D M.O. CASH
r m
i�0 ?> G 1 TiF i3j D ,o J
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
T
76A663 DBS 5A 3-50 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY ��������
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IW' DISTRICT NO. GROUP I ZONE PERMIT
ELECTRICIAN- �J
RECEIVED BY READY',FOR DATE ISSUED
ADDRESS C% �,p,J A p`h"1 .� ,' vQ_ .e // FIRST INSPECTION
CITY b"le, r40-/ A. g'r /., TEL NO. tV/J0!/�/
COUNTY LICENSE NO. �N� a EXPIRES .1d, e/I BUILDING /
PERMIT FEE ADDRESS .11 (/Ay(�®�
NUMBER EACH FEE
LOCALITY a'Ird F�[I
LIGHT OUTLETS BA NEAREST
RECEPTACLES Z) CROSS ST.
WALL SWITCHES /sd OWNER
TOTAL 'OUTLETS Sc $ - MAIL
ELEC. RANGES 25
ADDRESS
ELEC. HEATERS 25 � CITY )p--//Ff l(��1 ' i% TEL. NO.
FIXTURES 5
to
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
MISC. If
APPLICATION AND STATE THAT THE ABOVE 19 CORRECT
NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH. ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING.
MOTORS I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
NUMBER HORSEPOWER ANGELES COUNTY LICEnrOR AM THE LEGAL OWNER
FEE //
NEW MVD. HP OVER INC. EACH,; i Ji,:+ QF,ITHE:RESIDENTIAI. P O ERTY DE •RIBED ABOV,�. q
1 f i
FJ3T %z & LESS $ 2$'.t tAdkA:TURE OF
1/2 2 i 1riMITTE y
z s 1.00 INSPECTION REC
15 50 2.50
50 200 5.00 -'
200 500 10.00 J
Soo 1000 15.00 Z
OVER 1000 20.00 F3
M.G. SET/FREQ. CHANGER-HP Q'
WELDERS:AC-KVA O
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75% OF ORIG.)
MOVED MOTORS (75% GF ORIa.)
MISC.
SIGNS
NO. NO.TRANS.
APPROVALS
NO. NO.LAMPS
DATE INSPECTOR'S NAME
FOR EACH PERMIT:
WIRING $1.00 Q CONDUIT `:
FIXTURES _. $,1..QO ,.?�. WrR. _..; .A_ ,�.,, s.4, r•I
SUPPLEMENTARY _r :50' •r.. `.. ilFl>� Ed—
Pd ER
9 :POER -,..
TOTAL FEE ° $ UTILITY CO.NOTIFIED A a-
FINAL