HomeMy Public PortalAbout5418 MCCULLOCH AVE_Electrical__ 76.0663-CE806 10,72 APPLICATION FOR ELECTRICA�L'F ARMIT
COUNTY OF LOS ANGELES �g
DEPARTMENT OF COUNTY ENGINEER JOB
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BUILDING AND SAFETY DIVISION
LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
OUTLETS NO. EACH FEE OWNER OR -hI
FIRM NA v`r(�.+
RECEPT. S $ MAIL
ILI
FIRST 20 25 ` o0 ADDRESS
LIGHT T TAL OVER 20 CITY TEL. N
SWITCH .10 (! PLAN CHECK
LIGHTING FIRST 20 i .25 APPLICANT
TOTAL
OVER 20ADDRESS
FIXTURES H .10
RESIDENTIAL APPLIANCES CITY TEL. NO.
PERMIT
RANGE DRYER_WTR. HTR. APPLICANT y�
STA. COOK DISP. F.A.U. ADDRESS 0�
SPACE HTR. AIR GOND. q CITY TEL. NO.
CLOTHES WASH.— Z.DISHWASH..7 LICENSE OR yd
REG. NUMBER CLASS. V
FAN OTHER 1.00 U 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
IIILLL/// 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 I AM PROPERLY REGISTERED AND/OR
0 - I 1.00 G LICENSED AS REQUIRED BY LOS ANGELES CW NEOON AND STATE OF }
CALIFORNIA OR THAI I AM THE LEGAL OF THE ABOVE
1 - 10 3.00 DESCRIBED RESIDE►y I PROPERTY. CD
V
10 - 50 5,00 PERMITEE
SIGNATURE
F-
50 - 100 10.00 yV�
DISTRICT NO. PROC SSED
100 - 500 15.00 G '7�
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS l/ DATE INS R'S SIGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE
SERVICENOTOVER 600 VOLTS OR 200AMP 3.00 3 Q 7) UNDERSLAB WORK
SERVICEOVER 600 VOLTS OR 200AMP 10.00JRUGH CONDUIT
TEMP SERVICE,POLE,&APPURTENANCES 5.00RING _13_ y
TEMP LIGHT OR RECEPT. SYSTEM 3.00TURES
WER AUTHORIZED
ILITY CO. NOTIFIED ' e I r W. '
AL t-- ��� ,
PERMIT FEE (SUB TOTAL) TES:
PLAN CHECK FEE
PERMIT ISSUING FEE 3.00 3
TOTAL FEE
PLAN CHECK VALIDATION CK. M.O. , CASH PERM VALIDATION CK. _>4 0. CASH
5 Q, 9�`,4LJUN i ., 2 7.10 a�a
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE