HomeMy Public PortalAbout5356 MCCULLOCH AVE_Electrical__ (2) -16A663-C,E80611-71 APPLICATION FOR ELECTRICAL PERMIT
_ COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER ADDRESS .�p #71-Cf- VL-. L Q cm
:1 Elp.4'DINQ AND SAFETY DIVISION
53
LOCALI Yh L�� C
NEARET
FOR APPLICANT TO FILL IN CROSSS T. r Y\
OUTLETS NO. EACH FEE
OWNER
RECEPT.Z $ $ MAIL
ADDRESS
LIGHT_ TOTAL FIRST 20 25 � CITY IM ' TEL. NO �'3r
SWITCH OVER 20 ,10
PLAN HECK
LIGHTING TOTAL FIRST 20 .25 ` APPLICANT
FIXTURES _1_1 OVER 20 .10 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL. NO.
PERMIT
RANGE DRYER_WTR. HTR. APPLICANT
STA. COOK DISP. F.A.U. ADDRESS,
SPACE HTR. AIR COND. CITY TEL. NO.
CLOTHES WASH. DISHWASH. LICENSE NO.. CLASS.
FAN_J_OTHER 1.00 o O 1 HEREBY ACKNOWLEDGE THAT I 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
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
O - 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF d
CALIFORNIA OR THAT I AM.THE LEGAL OWNER OF, AND INTEND TO
1 - 1O 3.00 RESIDE IN, THE E DE IBED RESIDE AL PROPERTY.
V
SIGNATURE �
10 — 50 5.00 OF PERMITTEE O
SO'— 100 10.00 V F—
DISTRICT NO. CLASS ZONE PROCESSED BY W
100 — S00 15.00
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOTES: 1 V-73®' ' c.�` '�"�
TUBE, OR
MARQUEE 'ADDITIONAL CIRCUITS 1.00 1
SERVI CENOT OVER 600 VOLTS OR 200 AMP 3.00
SERVICEOVER600VOLTS OR200AMP 10.00 APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP.POWER POLE
TEMP SERVICE,POLE,&APPURTENANCES 5.00
TEMP LIGHT OR RECEPT. SYSTEM 8.00 UNDERSLAB WORK
ROUGH CONDIUTG
WIRIN '
j
FIXTURES
POWER AUTHORIZED
PERMIT FEE (SUB TOTAL)
UTILITY CO. NOTIFIED
PLAN CHECK FEE
PERMIT ISSUING FEE 3.00• 3 FINAIN
L ` ! . —l:
TOTAL FEE �2 ��
get /4w Gov, r
PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VAI IDAT ON CK. •fM. CASH
(I-A fo O 3 4 073 APR 2 2 D 5.2 J'' Q
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE