HomeMy Public PortalAbout5537 PAL MAL AVE_Electrical__ "•"'
12Al6• APPLICATION FOR ELECTRIC PERMIT
76A 68
. DIVISION OF BUILDING AND SAFETY
Department of County Engineer
County of Loc Angeles BUILDING
WM. J. FOX. COUNTY ENGINEER ADDRESS
CASSATT D. GRIFFIN. SUPT of BUILDING
FOR APPLICANT TO FILL IN LOCALITY
PERMIT FEES NEAREST
CROSS ST.
NUMBER EACH FEE
LIGHT OUTLETS OWNER e, o, �Ctfll= '
RECEPTACLES MAIL
1
ADDRESS
WALL SWITCHES •j
TOTAL OUTLETS _4- S CITY TEL. b
ELEC. RANGES 25 ELECTRICIAN DUS.1I14 ELECTRIC INC-
ELEC. HEATERS 25 ADDRESS 140.29 E. Ohio St. ED 7-CI.ID
KW EA CITY BALDWIN PARK TEL NO
FIXTURES 5 LICENSE NO. 154349
NUMBER OF LIGHT CIRCUITS DISTRLCT NO. GQ�UP ZON� EADY Fon INSPECTION
NUMBER OF RECEPTACLE CIRCUITS �(J�" .5 �e
MOTORS
NUMBER HORSEPOWER FEE INSPECTION RE1CORD
NEW MVD. HP OVER INC. EACH
Y2 B LESS S .25
2 .50 1
2 5 1.00 _
5 15 1.50 —
__ f5 50 2.50 _
5o 200 5.00
MISC.
NO. SIGNS NO TRANS.
NO. SIGNS NO. LAMPS
FOR EACH PERMIT:
WIRING St.00
FIXTURES
SUPPLEMENTARY .50 APPROVALS
TOTAL FEE S DATE INSPECTOR'S SIGNATURE
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP ICATION CONDUIT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING 44
ELECTRICAL WIRING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REOUIRED BY LOS ANGELES COUNTY AND STATE OF POWER
CALIFORNIA OR THAT 1 AM THE LEGAL OWNE OF THE ABOVE
DESCRIBED RESIDENTIgL P0.0PER Y.
UTILITY CO.NOTIFIE
SIGNATURE
D
OF PERMITTEE FINAL
WILLIAM J. FOX, COUNTY ENGINEER VALIDATION ,�4 T
.:_ 5
I 0502"S SEP 29
DEPUTY
® �l