HomeMy Public PortalAbout5422 PERSIMMON AVE_Electrical__ 76AG63C- CE8066 12/75 APPLICATION FOR ELECTRICAL PERMIT
BUILD AND SAFETY ISION
FOR APPLICANT TO RILL IN
New Residential Bldgs.&Pools EACH NO. FEE ADDRES.04 Cde r.1 4.0W0/t1
1 &2 Finaily Sq. Ft. $ — $ LOCALITY
Z 7-
Multi-family Sq.Ft. NEAREST
ROSS ST . ,s
Residential Swimming Pools OWNER O.
FIRM-NAME �` L Q O
Outlets: Light,Switch&Receptacle MAI L
First 20
ADDRESS ��S/„�/l/P/L0 Al
Additibnal CITY 7 . C. Tel. NO.
PLAN CHECK
APPLICANT
Lighting Fixtures
'
First 20 ADDRESS,
Additional
CITY Tel.NO.
PERFixed.Appliances Not Over 1 HP APPLICANT 44 L (J , J4 O L-X4 ELt.0
Range_ Heater_ D.W. ADDRESS�— 0fl/
Oven _ Dryer _ W.M.
Top _ FAU _ W.H. CITY 7�_, C ., Tel. No. �.
Hood Fan -� REG NUNSEMBER (p Class..
Disp. A.C.
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION 0
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY V
Power Apparatus&Large Appliances WITH. ALL COUNTY ORDINANCES AND STATE LAWS REGULATING W
Size&Type HP,KW,KVA,or KVAR ELECTRICAL WIRING. Q_
rn
Up to 1 Incl. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
Over 1 to 10 Incl. LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 A'M T LEGAL OWNER OF THE.A VE
Over 10 to 50 Incl. DESCRIBED RESIDENT L PRO R Y.
Over 50 to 100 Incl. PERMITEE
Over 100 SIGNATURE l�t�
DISTRICT NO. OC SED
Services � a
0-200 Amp. Under 600 V C�
201 -1000 Amp. Under 600'V APPROVALS DATE I PECTOR'S
Over 1000 Amp.or Over 600 V
/SIGNATURE
TEMP,POWER POLE
Temp.Power Pole&Appurtenances UNDERSLAB WORK
Sign with One Branch Circuit
Additional'Sign Branch Circuits ROUGH CONDUIT
(Other) WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FEE (Sub-Total) UTILITY CO.NOTIFIED
PLAN CHECKING FEE (One-Fourth Permit Fee) .�
FINAL'
PERMIT ISSUING FEE +
NOTES
TOTAL FEE
PLAN CHECK VALIDATION CK. M.O. CAS PERMIT VALIDATION— CK. M.O. CASH
3 '7 I NJRN 30 2 'D 1 2.1 0 e;38
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