HomeMy Public PortalAbout10457 LOWER AZUSA RD_Electrical__ :6A663-CE806 3-69
APPLICATION FOR ELEClifCAL PERMIl or
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER c )
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY
s
FOR APPLICANT TO FILL IN NEAREST
CROSS ST.
NO. EACH FEE
$ $ OWNER
RECEIPT. MAIL
LIGHT TOTAL
FIRST 20 ,20 ADDRESS
CITY TEL.N0.
SWITCH OVER 20 .10 PLAN CHECK
LIGHTING TOTAL FIRST 20 ,20 APPLICANT
FIXTURES OVER 20 .10 ADDRESS
RANGE_DRYER_WTR. HTR. CITY TEL.NO.
STA. COOK DISP. F.A.U. CONTRACTOR .C
SPACE HTR AIR COND. ADDRESS WSJ'
CLOTHES WASH. DISHWASH. CITY TEL.NO.
FAN OTHER 1.00 LICENSE NO. CLASS. C'10
MOTORS,TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
IND. HEATERS, ETC. HP. KW. KVA. AND STATE THAT TME ABOVE 15 CORRECT AND AGREE TO COMPLY
SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
O - 1 1.00 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSEDAS REQUIRED BY LOS ANGELES COUNTY AND STATEOF
1 - 10 3.00 CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF, AND INTEND TO d
RESIDE IN, THE ABOVE DESCRyBED RESID NTIAL PROPERTY. O
10 - 50 5.00 V
SIGNATURE
50 - 100 10.00 OF PERMITTEE Q
F-
100 - 500 15.00 DIST CT NOVGROUP ZONE SED BY d
SIGN,GAS SIGN AND ONE CIRCUIT 3.00 O _
TUBE, OR p �� Z
MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES:
LL 4 1
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 e" rf,-,l
SERVICE OVER 600 VOLTS OR 200 AMP 5.00
1 1
TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP. POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
WIRING
PERMIT FEE (SUB TOTAL) FIXTURES
POWER AUTHORIZED
PLAN CHECK FEE (50% PERMIT FEE)
PERMIT ISSUING FEE 2.00 2.
UTILITY CO.NOTIFIED
FINAL
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
t�L7 JOSEPH C. ROOHAN
TOTAL FEE SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION . CK. • M.O. CASH
2 D
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
76A663-CE806 3-69
f y.
APPLICATION
ATION FOR ELECTRICAL PERWT
COUNTY
• DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS &I
JOHN A. LAMBIE, COUNTY ENGINEER tj
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN - NEAREST
CROSS ST.
NO, EACH FEE
. $ $ OWNER
RECEIPT. MAIL
�/ /'P
ADDRESS./'O Zl
LIGHT �2 TOTAL FIRST 20 .20 ('�
SWITCH ^ OVER 20 ,10 CITY T L.NO.
PLAN CHECK
LIGHTING TOTAL FIRST 20 ,20 APPLICANT-
ADDRESS
FIXTURES }� OVER 20 .10
CITY TEL.N0.
RANGE_DRYER`WTR. HTR. _
STA. COOK
S� DISP. _F.A.U. CONTRACTOR
SPACE HTR FCI'R'C ONO.ImPt
ADDRESS
CLOTHES WASH._DISHWASH. CITY TEL.NO. /
FAN OTHER 1.00 - LICENSE NO. j 9' h 6 CLASS. , d
MOTORS,TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
IND. HEATERS, ETC. HP. KW. KVA. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
0 - 1 1'00 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
1 - 10 3.00 CALIFORNIA OR TH T I AM THE LEGAL OWNER OF, AND INTEND TO CL
RESIDE IN, THE A O E DESCRIBED RESIDENTIAL PROPERTY. O
10 - 50 5.00 V
SIGNATURE
50 - 100 10A0 OF PERMITTEE Q
F-
1OO - 500 15.00 DISTRICT GRZ Z{N E - PRO E SED W
SIGN,GAS SIGN AND ONE CIRCUIT 3.00
/lam(
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES:
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 - F` k'` `j-�`�+�/- "''
Yl
SERVICE OVER 600 VOLTS OR 200 AMP 5.00
TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP. POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT '
WIRING
FIXTURES
PERMIT FEE (SUB TOTAL)
POWER AUTHORIZED
PLAN CHECK FEE (50% PERMIT FEE)
PERMIT ISSUING FEE 2.00 Qb UTILITY CO.NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL
TOTAL FEE J SEPH C. ROOHAN
° SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CK. M.0. CASH
8 3 5010', NCJJ2 2 a 8.40
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE