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HomeMy Public PortalAbout9722 LONGDEN AVE_Electrical__ b9DBSA98.•SA8.99 9 APPLICATION FOR ELEC`TRI.0 PERMIT 1 DIVISION OF BUILDING AND SAFETY ' - Department of County Engineer CountyX of Los Angeles FDR •� WM.J.FO COUNTY ENGINEER . . !� CASSATT D.GRIFFIN,SUP-T-OR BUILDING A c FOR APPLICANT TO FILL IN .FEMv= FEES . NUMBER EACH FEE LIGHT OUTLETS OWNER. W RECEPTACLES MAIL' ADDRESS WALL SWITCHES TOTAL OUTLETS 5¢ $ D S ' CITY TEL. O. I`LEC.RANGES -• 25 • ELECTRICIAN o� ELEC. HEATERS 25 ADDRE S Sl 'KW EACITY FIXTURES TEL.NO. r' 5 a LICENSE NO. NUMBER OF LIGHT CIRCUITS - ;DISTRICTNO. JGROUPI ZONE I READY FOR INSPECTION NUMBER OF,RECEPTACLE CIRCUITS ° MOTORS ' NUMBER 1ioRSEPowER•, FEE INSPECTION RECORD ' NEW MVD. HP ,OVER INC. EACH ]/2 @ LE59 $. .25 - I fit 2 .50. rf 2 5 1.00' 5 15 1.80 15 50 1 2.50 "50. -200• 5..00 MISC. t NO.SIGNS NO.TRANS. NO.SIGNS NO.LAMPS FOR.EACH PERMIT:.. WIRING $1.00 r C n FIXTURES $1.00 ( v C, SUPPLEMENTARY .50 ' APPROVALS t TOTAL FEE S .� to l DATE INSPECTOR'S SIGNATURE I HEREBY ACKNOWLEDGE-THAT-1 .HAVE:READ THIS APPLICATION CONDUIT AND STATE THAT THE.ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY -ORDINANCES AND STATE LAWS REGULATINGWIRING / .I J O ELECTRICAL WIRING. I HEREBY CERTIFY THAT' 1 AM PROPERLY REGISTERED.AND/OR FIXTURES ��f LICENSED AS REQUIRED BY LOS ANGELES COUNTYAND..STATE OF • CALIFORNIA OR THAT I AM. THE LEGAL OWNER_ OF THE ABOVE POWER DESCRIBED•RESIDENTIAPROPE ? "SIGNATURE UTILITY CO.NOTIFIED /�.. -OF PERMITTEE FINAL WILLIAM J.FOX,COUNTY ENGINEER. VALIDATION A..C.VEIT,CHIEF ELECT.INSPECTOR :O 6 5 -.3•..A SEP 2.6 2 2.1'0 �"