HomeMy Public PortalAbout5344 MCCULLOCH AVE_Electrical__ 76A663-CEBOB 10/72 APPLICATION 'FOR ELECTRICAL. PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER JOB 1IA I
BUILDING AND SAFETY DIVISION ADDRESS ; 34 WiC ` G Cu
LOCALITY C f
NEAREST
FOR APPLICANT TO FILL IN CROSS.ST, v y'
OUTLETS NO. EACH I OWNER OR AA
FI RM:NAME L Y (�{�(°jl.L(R600
RECEPT. r S $ MAILADDRESS t�. C W i
LIGHT ` TO L FIRST 20 25
OVER 20 CITY C ° TEL. NO.LJLJI Cp
SWITCH •10 PLAN CHECK
LIGHTING TOTAL FIRST 20 25 APPLICANT
OVER 20 ADDRESS
FIXTURES ` .10
RESIDENTIAL APPLIANCES CITY TEL, N0.
PERMIT
RANGE _ . DRYER_WTR. HTR. APPLICANT
STA. COOK DISP. F..A.U. ADDRESS
SPACE HTR, AIR COND. CITY TEL. NO.
CLOTHES WASH. DISHWASH, LICENSE OR
REG. NUMBER CLASS.,
FAN OTHER 1.00 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
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
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 — 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAI I AM THE LEGAL OWNER OF THE ABOVE
1 _ 10 3.00 DESCRIBED RESIDENTIAL PROPERTY.
r f O
PERM'ITEE ` l ` / v
10 — 50 5.00 SIGNATURE ° l O�G�IA
C
50 —100 10.00 �
DISTRICT N0. PROCESSED BY LLS
100 — 500 t5.00 y
e 5, v Z_
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTOR'S SIGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP: POWER POLE
SERVICENOTOVER 600 VOLTS OR 200AMP 3.00 UNDERSLAB WORK
SERVICEOVER 600 VOLTS OR 200AMP 10,00 ROUGH CONDUIT
TEMP SERVICE,POLE,IN APPURTENANCES 5.00tFR
TEMP LIGHT OR RECEPT, SYSTEM 3.00 /r
AUTHORIZED-
UTILITY . NOTIFIED q /
PERMIT FEE (SUB TOTAL)
PLAN CHECK FEE
PERMIT ISSUING FEE 3:00 TOTAL FEE
PLAN CHECK VALIDATION _ CK. M.0. CASH PERMIT VALIDATION CK. M.O. CAS
9103q IhIaV z2 2'0 5.5 0 A,�j8
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE