HomeMy Public PortalAbout5541 PAL MAL AVE_Electrical__ ]6A683{E606 46 APPLICATION FOR ELECTRICi:L P&T v
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING
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BUILDING AND SAFETY DIVISION ADDRESS _
---dOHN A. LAMBIE, COUNTY ENGINEER i
COLEMAN W. JENKINS. SUPT. OF BUILDING LOCALITY
NEAREST d
FO CROSS ST.
RECEPTACLE 1 TOTAL NO. EACH PER
LIGHT l OUTLETS i FIRST 20 09.20S MWNER
AIL
SWITCH 1 ADD'L 7O ADDRESS
OVER 20 - 79777
I
TOTAL FIRST 20 .20 Clry TEL. NO.
LIGHTING 1 FIXT RES
FIXTURp J( ADD•L 10 CONTRACT R
OVER YO
PaANO[s CLO.DRYGS WTI.MRS. 1.00 ADDRESS O .�
DAM.DIA. RA.COOK CITY TEL NO. -�2
DISHWASN. AUTO.•WASH. STATE ��/T
.,I.,
HTP. / STA.APP.IN NO.MAY.) .50 LICENSE NO. C2
MOTORS, OVER NOT OVER HJ. DISTRICT NO. GROUP ZONE I PR ESSED
O 1 1.00
1 a 11.80 INSPECTION RECORD
a S 2.00 At
a Is 2.50 --
1s so 3.00 I !
so foo 5.00ae
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NO.TITANS0
. _��4
SIGNS, NO.LAMPS O
G
W
SERVICE O•SOOV.Nm OVER 200A 1.00 H
SERVICE O•SOOV•OVER 200 A. 2.00 Z
SERVICE OVER SOOV 5.00
OTHER UE[ COMPLETE FEL SCHEDULE)
PERMIT ISSUING FEE 2.00
SUPPLEMENTAVY PERMIT ISSUING FE[ 1.00 -
TOTAL FEE S '11j APP
ROVALS DATE INSPECTOR'S SIGNATURE
I HERESY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION UNDERSLAB WORK
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ROUGH CONDUIT ��
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING I )11
IHERESY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE 01
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF.AND INTENO TO POWER
RESIDE IN.THE E DESCRIBED RE91O IAL PROPERTY.
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITTE .44
FINAL
CX MO G
ION JOSEPH C. N
C[ MO SM SUPERVISINGG ELECTRICAL ENGINEER
9
L�8 6 5� JAN 7 2 D 8.40~ 1
T.r�P1e C�ty n
76A663 CE80fi 1-68 APPLICATION FOR ELECTRICAL PERMIT ��JI
COUNTYOFATNT OF L,NS ALINNGELES
DEBUIL DING AND $IA FETYY DIV SINNER BUILDING
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JOHN A. LAMBIE. COUNTY ENGINEEADDRESS R/ L�/7//C
COLEMAN W. JENKINS, SUPERINTENDENT OFR BUILDING LOCALITY eA LL C/r
FOR APPLICANT TO FILL IN CROSS ST. � OAj T C7 (z
NO. AC FEE
RECEPT.— 5 S OWNER
MAIL �P
LIGHT_ TOTAL FIRST 20 .20 Q ADDRESS .r /' y/�` 8
SWITCH OVER 20 .10 CITY IP C. TEL. NO. - /
PLAN CHE K
LIGHTING TOTAL FIRST 20 .20 APPLICANT
FI%TURES OVER 20 .10 ADDRESS
RANGE_DRYER_WTR.HTR.— CITY TEL. NO.
STA.COOK_DISP.-L-F.A.U._ CONTRACTOR
SPACE HTR.—AIR COND.— ADDRESS
CLOTHES WASH.—DISHWASH. I CITY TEL. NO.
FAN_OTHER 1.00 o LICENSE NO. CLASS.
MOTORS.TRANSFORMERS RATING
IND. HEATERS, ETC. HP. KW. KVA. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE & TYPE OVER TO AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY OROINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
0 1 1.00
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
1 - 10 3.00 LICENSED AS REOUIREO BY LOS ANGELES COUNTY AND STATE OF }
CALVORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO CL
10 - 50 5.00 RESIDE IN, THE A OVE D CRIPED RE DE L PROPERTY. O
SIGNATURE I Y U
50 - 100 10.00 OF PERMITTE CC
100 - 500 15.0 DISTRICT NO. GROUP &O E P OCESSED BY O
SIGN,GAS SIGH AMC ONE CIRCUIT 3.00 W
TUBE, OR d
MARQUEE ADGITIONAL CIRCUITS 1.00 NOT Z
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00
AAA
SERVICE OVER 600 VOLTS OR 200 AMP 5.00
TEMP SERVICE. POLE. 6 APPURTENANCES 3.00ftDATCEPROVALS DATE INSPECTOR'S SIGNATURE
OWER POLE
AS WORKONDUITPERMIT FEE (SUBTOTAL) SPLAN CHECK FEE (50% PERMIT FEE) UTHORIZED i 4:57
PERMIT ISSUING FEE2.00 CO.N OTI F IEDSUPPLEMENTARY PERMIT ISSUING FEE 1.00 ITOTAL FEE IF JOSE C. ROOHAN
SUPERVISING ELECTRICAL ER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M. CASH
s a/2 Ot8 .uL11 2 0
420-
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE ( � �
COUNTY OF LOB ANGELES APPLICATION FOR PERMIT `
Department OF GI County ED hum
SAF ELECTRIC 1
DIVISION of sIIn.Dn�c aL SAFETY
WILLIAM 1 FOX, C[DDb EEEID[N
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PE��1R///M'''111IT NO.
ELECTRICIAN e
AGGRESS RECEIVED BY FIRSTREADYPECTIOM Y mi DA7 I(B^OU
CITY TEL NO e� "'
COUNTY LICENSE NO EXPIRES BUILDING S/
PERMIT FEES ADORsae 7 eIT IOIL4�100`.71
NUMBER LAOS R[ LOCALITY
LIGHT OUTLETS M[ARLST
RECEPTACLES CRS
WALL SWITCHES OWNER
ScTOTAL OUTLETSD MAIL
EL[C RANGES IIS ADDRESS
ELEO HEATERS 90 CITT41, TEL NO
FIXTURCB 6
1 H[R[BY AOKNCWL[ THAT 1 HAVE R[AD THIS
MIBC APPLICATION AND BTATE THAT THE ABOVE IB CORRECT
NUMBER OF LIGHT CIRCUITS AND ABREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING
MOTORS 1 CERTI►Y THAT I POSSESS THE ABOVE VALID LOB
NUMe[s HORB[POWER F6E ANDELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER
Nnv Mw NP DYES ISD r...H OF THE RESIDENTIOLPROPERTY DESCRIBED E
A uM IG 25 BIGNATUp[ or
B BO PERMITTE
B S 100 INSPECTION PKIECORD
S is 1 sO
is so 930 A
50 ZOO s DO
700 500 1 G DO -L J
SOO low 15130 =
OVER lOOO 8000 p
M O BET FRED CHANGER-HP G;
WELDERS AO-KVA O
GENERATORS - KW
TRANSFORMERS - KVA
TEMP MOTORS (76 DF DEID)
MOVED MOTORS (73 of GRID
MIBC
SIGNS
N4 TRANS. APPROVALS
NCOOPB
FOR EACH PERMITS DATE INSPE R•BNAME
WIRING $1.001 CONDUIT
FIXTURES 1111 0131 100WIRING
SUPPLEMENTARY Sol I FIXTUR[B
h
0 POWER
TOTAL FEE B UTILITY CO NOTIFIED
FINAL
76 . 1 DBD#M L-e]