HomeMy Public PortalAbout5634 PAL MAL AVE_Electrical__ Db%5A APPLICATION FOR ELECTRIC PERMIT
Deo 0A J EJ
DIVISION OF BUILDING AND SAFETY
Deportment of Commtp Engmeec
Coontgof Los An elect BUILDING
WM J FOX COUNTY ENGINEER ADDRESS
CASSATTD GRIFFIN SUPTOFBUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST1
PERMT FEES CROSS ST
NUMBER EACH I FEE
OWNER
LIGHT OUTLETS
RECEPTACLES MAIL
ADDRESS
WALL SWITCHES _
TOTAL OUTLETS 52 S CITY TEL NO
ELEC RANGES 25 ELECTRICIAN I
_ELEC HEATERS 25 _ADDRESS L !. A
KW EA CITY TEL NO
FIXTURES b LICENSE NO
NUMBER OF LIGHT CIRCUITS - DISTRICT T NO I GROUP hN% REAO�a, ENSPRCTIOx
NUMBER OF RECEPTACLE CIRCUITS OL��' L �.V
MOTORS
rvUMOER HORSEPOWER FEE INSPECTION RECORD
NEW MVD HP OVER INC EACH
e LE6J S 25
h 2 50
2 5 100
5 15 1 50
15 50 2 50
50 200 1 Soo
MISC
NO SIGNS NO TRANS
NO SIGNS NO LAMPS
FOR EACH PERMIT
WIRING $100
FIXTURES SI 00
SUPPLEMENTARY 50 APPROVALS
TOTAL FEE .f DATE INSPECTOR S SIGNATURE
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS 1 TION CONDUIT
AND STATE THAT THE ABOVE IS CORRECT AND AGREEL'b id PLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS !W LATINS WIRING
ELECTRICAL WIRING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT,I AN THE LEGAL OWNER OF THE ABOVE POWER
DESCRIBED RESIDENTIAL PROPERTY
SIGNATURE UTILITYCO NOTIFIED
OF PERM ITTEE Arm FINAL
WILLIAM J FOX. COUNTY ENGINEER VALIDATION A C VEIT,CHIEF,ELECT INSPECTOR
} 'D 4 3'2 5 MAR 21 2
225
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