HomeMy Public PortalAbout9091 LYLEDALE ST_Electrical__ 7.6A663 PLICATION FOR
D06.5A 12.54AP
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`DIVISION OF BUILDING AND- SAFETY
Departnient of County Engineer
! County of Los Angeles BUILDING"
WM. J. FOR. CO UNTY.ENGINEER ADDRESS v
CASSATT D. GRIFFLN, SUP'?OF BUILDING -
LOCALITY
-
FOR APPLICANT TO FILL IN '
PERMIT. FEES NEAREST CROSS ST.
rc
.. FEE -
NUMSER -EACH n �•�' ,rte.
LIGHT OUTLETS OWNER
RECEPTACLES - ADDRESS /J /O D /—4{`
WALL SWITCHES ® _ /+ - -
TOTAL OUTLETS 50 S- .7-S CITY ,—, F''G pii EL.'NO.
ELEC. RANGES 25 ELECTRICIANt
ELEC.-HEATERS. -25 ADDRESS . lea
.00W ,,,
KEA CITY _ ,w_yet�ti, TEL Mn ° o
FIXTURES 5.. 'T LICENSE NO. asy �G&l3
NUMBER OF LIGHT CIRCUITS.
DISTRICT NO. GROUP ZONE READY FOR INSPECTION
NUMBER OF RECEPTACLE CIRCUITS
MOTORS .
NUMBER HORSEPOWER FEEINSPECTION'RECORD '
TNEW MVD. —HPP OVE�Rpy INC. EACH
11/2 a}LESS
r
Yz . 2 50
2 5 1.00 - -
5 15 1:50. '
l5 50 2.50 - -
50 200 5.00- -
MISC.
NO. SIGNS NO. TRANS.
NO. SIGNS NO. LAMPS -
.FOR EACH PERMIT: -
WIRING - $1.00 • '
FIXTURES _.. $1.00
SUPPLEMENTARY . .50
APPROVALS
TOTAL FEE. - $ •• 0 '� - DATE INSPECTOR=S SIGNATURE
I I_HEREBY ACKNOWLEDGE THAT C HAVE READ THIS*APPLICATION CONDUIT a
AND STATE THAT THE ABOVE ICORRECT AND AGREE COMPLY
WITH ALL COUNTY= ORDINANCES
S AND STATE LAWS REGULATING WIRING
ELECTRICAL WIRING.
I HEREBY CERTIFY THAT I 'AM PROPERLY REGISTERED--AND/OR FIXTURES
LICENSED ASREGUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT. I AM THE•LEGAL OWNER OF THEpABOVE POWER
DESCRIBED RESIDENTIAL PROP
ERTY:' _ UTILITY CO.NOTIFIED `'7.' �' � 1Q/•�
SIGNATURE
OF PERMITTEE (/ a—� �• FINAL U •M
WILLIAM J. FOX,COUNTY ENGINEER VALIDTI�N� r2'� ._gyp `
_ R29. z 4 .4,5
- DEPUTY