HomeMy Public PortalAbout5516 PAL MAL AVE_Electrical__ DBS-DES DA APPLICATION FOR ELECTRIC PERMIT I
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DIVISION OF BUILDING AND SAFETY
Department of County Engineer {
County of Los Angeles BUILD(s e3 �J'V/� Al /n/.¢L
WM. J. FOX. COUNTY ENGINEER ADDRES
CASSATT D. GRIFFIN, SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PERMIT FEES CROSS ST.
LIGHT OUTLETS NUMBER EACH FEE
OWNER l
RECEPTACLES MAIL
ADDRESS
WALL SWITCHES
TOTALOUTLETS 50 i CITY TE NO.
ELEC.RANGES 25 ELECTRICIAN H
ELEC. HEATERS 25 ADDRESS ••
KW EA CITY TEL.NO.A-/J/SE to
FIXTURES 5 LICENSE NO. ry S f'
NUMBER OF LIGHT CIRCUITS - DISTRICT NO. ( GROUP ANREADT FOR InavicTloR
NUMBER OF RECEPTACLE CIRCUITS
MOTORS bpd'
NUMBER HORSEPOWER FEE INSPECTION RECORD
NEW I MVD. HP OVER INC. EACH -
fJY2 eLEBs s .zs ZOO
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z .50 ' S
2 5 1.00
5 15 1.50
15 50 2.50
so zoo 5.00 _ doe
v r
MISC.
NO.SIGNS NO.TRANS.
NO.SIGNS NO. LAMPS
FOR EACH PERMIT:
WIRING SLOG
FIXTURES $1.00
SUPPLEMENTARY .50 APPROVALS ,j p ,-
TOTAL FEE s �J' 1 DATE IUP5QTOR'S5IQPlATIJRE
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION CONDUIT LL f,
AND STATE THAT THE ABOYE IS CORRECT AXD AGREE TO COMPLY
WITH ALL COURjY ORDINANCES AND STATE LAWS REGULATING WIRING AL1'
ELECTRICAL WIRING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES 2,2,'
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE POWER
DESCRIBED RESIDENTIAL PROP RTY.
SIGNATURE I/ UTILITY CO.NOTIFIE '1.'
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II
OFPERMITTEE FINAL 'Z7. S7. � '��.'.1 �.1P
WILLIAM J.FOX. COUNTY ENGINEER VALIDATION A. C.VEIT. CHIEF ELECT. INSPECTOR
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