HomeMy Public PortalAbout5356 MCCULLOCH AVE_Electrical__ 76A563-&SO611-71 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BPI.-DINlis AND SAFETY DIVISION ADDRESS �.� Ip VL.. L- 4 CM
LOCALI Vh L-V- C
NEAREST _
FOR APPLICANT TO FIL.L IN CROSS ST. �, / t �\
OUTLETS NO. EACH FEE
$ $ OWNER
RECEPT. MAIL
FIRST 20ADDRESS
LIGHT TOTAL 25 O CITY RnSp l TEL. NO -If
SWITCH OVER 20 .10
PLAN HECK
LIGHTING FIRST 20 .25 Q APPLICANT
TOTAL
FIXTURES 20 .10 ADDRESS
OVER
RESIDENTIAL APPLIANCES CITY TEL. NO.
PERMIT
RANGE DRYER_WTR. HTR.. APPLICANT
STA. COOK DISP. F.A.U. ADDRESS.
SPACE HTR. AIR GOND. CITY TEL. NO.
CLOTHES WASH. DISHWASH. LICENSE N0. CLASS.
FAN OTHER1.00 O /y t HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
V 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 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
I - 10 3.00 RESIDE IN, THE E DE IBED RESID AL PROPERTY. V
SIGNATURE I,
10 - 50 5.00 OF PERMITTEE O
50 - 100 10.00ri
DISTRICT NO. CLASS ZONE PROC E59 ED BY 1U
100 - S00 15.00 d i_ ° o.
y
SIGN, GASSIGN AND ONE CIRCUIT 5.00 NOTES: ?
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 '+ � A,160 .@
SERVICE NOTOVER 600 VOLTS OR 200 AMP 3.00
APPROVALS DATE INSPECTOR'S SIGNATURE
SERVICE OVER 600 VOLTS OR 200 AMP f0.00
TEMP.POWER POLE
TEMP SERVICE,POLE,IN APPURTENANCES 5.00
TEMP LIGHT OR RECEPT. SYSTEM 3.00 UNDERSLAB WORK
ROUGH CONDIUT -
WIRING 09 71.E E9 r!
FIXTURES
POWER AUTHORIZED
PERMIT FEE (SUB TOTAL)
UTILITY CO. NOTIFIED ,
PLAN CHECK FEE 1 /
l - f✓
FINAL K '
PERMIT ISSUING FEE 3.00 (f
TOTAL FEE
PLAN CHECK VALIDATION CK. M.D. CASH PERMIT VAI IDA T ON cK. M. CASH
C 34 073 r1PR 2 2 D J`'2 5
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE