HomeMy Public PortalAbout5430 MCCULLOCH AVE_Electrical__ U
78p663-CE806 ,D,77� APPLICATION FOR ELECTRICAL FERMIl*D
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER JOB
BUILDING AND SAFETY DIVISION ADDRESS 7 1d
LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
OUTLETS N0, EACH FEE OWNER OR
FIRM NA
RECEPT. $ $ MAIL
LIGHT TOTAL
FIRST 20 25 ADDRESS L
_
CITY TEL. NO.�+j
SWITCH OVER 20 .f0 og
PLAN CHECK
FIRST 20P5 APPLICANT
LIGHTING TOTAL
OVER 20 ADDRESS
FIXTURES �. .10
RESIDENTIAL APPLIANCES CITY TEL. N0.
PERMIT \ 1
RANGE DRYER_WTR. HTR. APPLICANT
STA. COOK DISP.-/-F.A.U. ADDRE 8
SPACE HTR. AIR COND. CITY r TEL. N 2
CLOTHES WASH. DISHWASH-1- LICENSE 0
REG. NUMBE CLASS
FAN OTHER1.00 I 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 I HEREBY CERTIFY THAT 1 AM PROPERLY ISTERED AND/OR
O - 1 100 fV1 LICENSED AS REQUIRED BY LOS ANGELES COU Y AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWN R OF THE ABOVE .r
1 - 1O 9.00 DESCRIBED RRESI AL PROPERTY. G
RERMITEE v
10 - 50 5.00 SIGNATUR 0
50 - 100 10.00 8
DISTRICT NO. �g PROCES D BY Iy
100 - 500 15.00
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS V DATE INSPECTOR'S SIGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE
SERVICENOTOVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK
SERVICEOVER600 VOLTS OR200AMP 10.00 ROUGH CONDUIT
TEMP SERVICE,POLE, &APPURTENANCES 5.01D WIRING 3�L� � %f9:��
TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES ®/ti— _ •��rN
POWER AUTHORIZED
UTILITY CO. NOTIFIED 7A
FINAL /���.�75 Y
PERMIT FEE (SUB TOTAL) NOTES:
PLAN CHECK FEE
PERMIT ISSUING FEE 3.00 &-6
TOTAL FEE G
PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CK. .O. CASH
5 0 It--JUN 14 2 10 1 $.0 5 AS8
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE ���