HomeMy Public PortalAbout5827 MYDA AVE_Electrical__ 76A868-CE806 12/7.5APPLICATIO'N FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEERJOB
BUILDING AND SAFETY DIVISION ADDRESS
FOR PP T LOCALITY
New Residential Bldgs&Pools EACH NO. FEE NEAREST
1 & 2-Family,Sq. Ft. $ .025 — $ CROSS ST. Q_
Multi-family Sq. Ft. ,02 — OWNER /
Residential Swimming Pools 20.00 MAIL
ADDRESS
Outlets: Light,Switch & Receptacle CITY Tel.No�J/��Val
First 20 •50 PLAN CHECK
Additional .30 APPLICANT
ADDRESS
Lighting'Fixtures
First 20 .50 CITY Tel.No.
Additional 30 PERMIT
APPLICAN
Fixed Appliances Not Over 1 HP - ADDRESS sy0�
r
Range_HeateD.W._ CITY e� 'TeI.No �9
Oven_'Dryer_W.M._ LICENSE OR
Top_ FAU _W.H._ REG.NUMBERpZ��j Q� CIasS.e-1g)
Hood_ Fan ___
Dlsp_A.C. _ 2.00 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
Power Apparatus& Large Appliances . ELECTRICAL WIRING.
SIZe Type HP, KW, KVA,or KVAR Z I HEREBY CERTIFY THAT I ANI PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY 'ANDSTATE OF
Up to 1 Incl. 2.00 CALIFORNIA OR THAI I AM THE LEGAL OWNER OF THE ABOVE
Over 1 to 10 Incl.
5.00 DESCRIBED RESIDENTIAL PROPERTY.
Over 10 to 50 Incl. 10.00 PERMITEE
.Over 50 to 100 Incl. 20.00
SIGNATURE
Over 100 30.00 [DISTRICT NO. P ESS Y 0Services ' O
0- 200 Amp. Under 600 V 12.50 I INSPECTOR'S
201.1000 Amp. Under 600 V 25.00 APPROVALS DA SIGNATURE Ub
Over 1000 Amp.or Over 600 V 50.00 P.POWER POLE
Temp..Power Pole&A 'UNDERSLAB WORK
Appurtenances 10.00
Sign with One Branch Circuit 10.00 ROUGH CONDUIT
Additional Sign Branch Circuits 2.00 WIRING
(Other)
FIXTURES
POWER AUTHORIZED
UTILITY CO.NOTIFIED
FINAL
PERMIT FEE (SubrTotal) NOTES
PLAN CHECKING FEE '(One-Fourth Permit Fee)
,PERMIT ISSUING FEE $6.00
(TOTAL FEE
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION K. MO. CASH
0 Sit NOV y ; U (.J 0 bac
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE (�