HomeMy Public PortalAbout5010 PAL MAL AVE_Electrical__ 76AG63-CES06 8-69
APPUCATI®N FOR ELECAICAL PE IT
'COUNTY OF LOS ANGELES
DEPAR'rMENT`OF COUNTY ENGINEER BUILDING Pal Mal
BUILDING AND SAFETY DIVISION ADDRESS 010 No
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
NO. EACH FEE
$ $ OWNER
RECEIPT. MAIL
LIGHT TOTAL
FIRST 20 ,20 ADDRESS S me
CITY TEL.N0.
SWITCH OVER 20 .10 PLAN CHECK
LIGHTING TOTAL FIRST 20 .20 60 APPLICANT
FIXTURES OVER 20 ,10 ADDRESS
RANGE_DRYER_WTR. HTR. CITY ����77 TEL.NO.
STA. COOK_DISP._F.A.U. CONTRACTOIYarr Electric
SPACE HTR. AIR COND. ADEIRESS15737
y 1 TOld Valle Blvd
CLOTHES WASH._DISHWASH.
CI O.F.' O tr TEL.NO. 0 1
a
FAN_OTHER 1.00 LICENSE NO.250843 CLASS.CQ 10
MOTORS,TRANSFORMERS RATING 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
IND. HEATERS, ETC. HP. KW. KVA. AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
0 - 1 1'00 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGE 9 COUNTY AND STATEOF
1 - 10 3.00 CALIFORNIA OR THAT 1 AM THE LEGAL WNER OF, AND INTEND TO
RESIDE IN, THE ABOVE �SCRI ED R IDENTI AL PROPERTY. /
10 — 50 5.00 . IL
SIG URE �
50 — 100 10A0 OF
100 - 500 15.00 DI SriT N0. GRO ZO E PR C 3E
u
SIGN GAS SIGN AND ONE CIRCUIT 3.00 V
TUBE, OR L
MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES:
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00
SERVICE OVER 600 VOLTS OR 200 AMP 5.00
TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP. POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
WIRING ()
PERMIT FEE (SUB TOTAL) LVO FIXTURES
17
�d
PLAN CHECK FEE (50°k PERMIT FEE) POWER AUTHORIZED
PERMIT ISSUING FEE 2.00 2 00 UTILITY CO.NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
FINAL df- r 1
TOTAL FEE 9 JOSEPH C. ROOHAN
SUPERVISING ELECT ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
( nr-:6 0 44 CIE" JLL 2 4. . 2 D .G.6 0/~
SEE.BACK OF APPLICATION FOR COMPLETF FEE SCHFOUI.F. //�(