HomeMy Public PortalAbout5428 PERSIMMON AVE_Electrical__ 76A668 CE-806R 9/76 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER FADDRESS .
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN Y ( C
New Residential Bldgs.&Pools EACH NO. 7FEEE1 &2-Family,Sq.Ft. $ .025 — $ OR Q
Multi-family Sq.Ft. •02 — FIRM NAME
Residential Swimming Pools 20.00 MAIL
ADDRESS S A-5 R f 0AI
Outlets:Rec _Light_Sw. CITY "Fc C , Tel.No.
First 20 .50 PLAN CHECK
Total No.• Additional .30 APPLICANT
ADDRESS
Lighting Fixtures First 20 .50 CITY Tel.No.
Total No. Additional 30 APPLICANT
Fixed Appliances Not Over 1 HP ADDRESS F S G
Range_Heater_D.W._ CITY C , Tel.No. _
Oven_Dryer_W.M. LICENSE OR
Top —FAU —W.H._ REG.NUMBER (p Class., a
Hood_Fan _Other_ �o/� 1 HEREBY ACKNOWLEDGE.THAT I HAVE READ THIS APPLICATION AND STATE
Disp. _Room Air Cond. 2'00 °^ THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDIN-
ANCES AND STATE LAWS REGULATING ELECTRICAL WIRING.
Power Apparatus&Large Appliances
Size&Type HP,KW,KVA,or KVAR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS
'2.00 REQUIRED BY LOS ANGELES COU. Y AND STATE OF CALIFORNIA OR THAT I AM
Up to 1 Incl. THE LEGAL OWNEROF'HE ABO .D CRIBED RESIDENTIAL PROPERT ,
Over 1 to 10 Incl. 5.00
Over 10 to 50 Incl. 10.00 PERMITTEE Q
20.00 SIGNATURE U
Over 50 to 100 Inc. � �
Over 100 30:00 DISTRICT NO .. ROCES tD BY
Services 094
r
0-200 Amp.Under 600 V 12.50 INSP OR'S A
APPROVALS DATE SIGNATURE Z
25.00
201-1000 Amp.Under 600 V v
Over 1000 Amp.or Over 600 V 50.00 TEMP.POWER POLE
Temp.Power Pole&Appurtenances
10.00 UNDERSLAB WORK
Sign with One Branch Circuit 10.00 ROUGH CONDUIT
Additional Sign Branch Circuits
2.00 WIRING
Misc.Conduits&Conductors 15.00 FIXTURES
Other(See Complete Fee Schedule) POWER AUTHORIZED.
UTILITY CO.NOTIFIED
FINAL
PERMIT FEE (Sub-Tot all NOTES
PLAN CHECKING FEE (One-Fourth Permit Feel �-
PERMIT ISSUING FEE $6.00
TOTAL FEE
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
9 2 O r AUG 1 2 0 1 3.9 0 ,&-,r,
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE ®s
76A669-CE806 -62 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING 7�
BUILDING AND SAFETY DIVISION ADDRESS dL
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
7RECEPT. TOTAL NO. EACHOUTLETS FIRST 20 $2O S OWNER
MAIL
ADD'L t0ADDRESS
OVER 20
T
TOTAL Y EL.NO.
LIGHTING 1 F1Rsr20l 20 CIT
FIXTURES 1 ADD'L1O ELECTRICIAN C.-�)
OVIM 20 cc_
RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRES fY 3 S. 4;_wl rl=444a
GARB.DISP. / STA.COOK CITY TEL.NO. f
DISHWASH. AUTO.-WASH. STATE
SPACE HTRS. STA.APP.(%X.P.MAX.) ' .50 LICENSE NO.
MOTORS: OVER NOT OVER H.P. DISTRI T N & r.RfluPZONE I PRiSSED BY
i
0 1 1.00 ' r L•. -''
1 s 1.50 INSPECTION RECORD
s S 2.00
di
8 is 2.50 1
1s 50 9.00 / v
s0 too 5.00 II '' O
SIGNS: NO.TRANS.
!�
NO.LAMPS pO
SERVICE 0-600V-Nor OVER 200A 1.00
Lu
SERVICE 0.600V-OVER 200 A. 2.00 H
SERVICE OVER 600V 5.00 Z
MISC.
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE It
3
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOW881GNATURE
AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES'AND STATE LAWS REGULATING JA'
ELECTRICAL WIRING. WIRING
1 HEREBY CERTIFY THAT 1 AM PROPERLY.REGISTERED AND/OR
LICENSED AB REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES ��Cl� 1,1
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE t `
DESCRIBED RESIDENTIAL PROPERTY. ` POWER S ,f
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITTEE cccc r '
FINAL ^4Zt
LIDATION ARTHUR C. VEIT
e CK y MO CASH SUPERVISING ELECTRICAL ENGINEER