HomeMy Public PortalAbout5415 PAL MAL AVE_Electrical__ 76A663.CEBOG I0-62 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING /
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER ,-
WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY �'
NEAREST
R APPLICANT TO FILL IN CROSS ST.
17--
. TOTAL NO. EACH FEE /
OUTLETS FIRST 20 5 2O 9 OWNER vim'
L
�/F/ MAIL11111 ^ w00'L ADDRESS ✓� ? .v
X. f C/ OVER 2G •1GTOTAL CITY / TEL.NO.ING FIRST 20 .20URES ADD'L 0 / ELECTRICIANOVER 2GES CLO.ORYERB R. RS. 1.00 ADDRESS
IBP. STA.COOK V `�/ CITY TEL.SH. / AUTO.-WASH. STATE TIUL STA.APP.(lAH.P.MAX.) ,BO •) LICEN ENO. ni
S: VER NOT OVER H.P."- DISTJ2IC NO. GROUP Z NE P SSED BY
O 1 1.00e%2.�1 3 1.50 INSPECTION RECORD
3 B 2.00B 15 2.So 15 50 3.0050 100 5.00: NO.TRANS.NO.LAMPSE O-BOOV-NoT OVER 200A 1.00
SERVICE O-SOON OVER 200 A. 2.00
SERVICE OVER 600V 5.00 1
MISC.
PERMIT ISSUING FEE 12.0011
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE 6
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. 'WIRING 4 t
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
CE /
LICENSED AS REQUIRED BY LOS A
NCOUNTY AN S TE OF FIXTURESCALIFORNIA OR THATTHEOWN R OF ABOVEDESCRIBED RESIDENTIAL ERTPOWER
SIGNATURE '� UTILITY CO.NOTIFIED
OF PERMITTEE
FINAL
VALIDATION MO CASH A R C: VETT
SUPERVISING ELECTRICAL ENGINEER
CK
LjD343yw DEC12 2 D 16.20-