HomeMy Public PortalAbout5957 PRIMROSE AVE_Electrical__ DBS.SA 12-54 APPLICATION FOR ELECTRIC PERMIT
DIVISION OF BUILDING AND SAFETY
Departmentof
County Z:n
Engineer
of Angeles BUILDING
WM.J.FOX. COUNTY ENGINEER ADDRESS
CASSATT D.GRIFFIN.SUPT OF BUILDING
aTTEEPRIMM� I
FOR APPLICANTT
TO FILL IN LOCALITYNEAREST
PERMIT FEW
FEE I,ZCROSS ST.
, NUMBER EACH I
-
LIGHT.OUTLETS OWNERMY-
MAIL
RECEPTACLES • MAIL
WALL SWITCHES
TOTAL OUTLETS 5k S CITY TEL-_-.N0_- _&_
ELEC. RANGES
ELECTRICIAN .4"_
ELEC.HEATERS 25 ADDRESS tl
KW EA CITY qQ_4A9e_oA4 TEL.NOgyl=7
FIXTURES 5 LICENSE NO.
NUMBER OF LIGHT CIRCUITS _ Alw.'0l='!MECTI0N
DISTRICIPO. IGROUP Zqk) RE
NUMBEROFRECEPTACLE,CIRCUITS 0.1
MOTORS '.07
NUMBER HORSEPOWER FEE INSPECTION RECORD
NEW NVD, HF- OVER INC. EACH
&LESS S .25
16 2 So
2 5 1.00
5 1*5 "50
15 50 2.50
200 15.00
MISC.
NO.SIGNS NO.TRANS.
NO.SIGNS NO. LAMPS
FOR EACH PERMIT:
WIRING $1.00
FIXTURES S1.001 I
SUPPLEMENTARY .a..0 APPROVALS
TOTAL FEE s TE INSPECTOR'S SIGNATURE
HEREBY ACKNOWLEDGE THAT I HAVE.jtEAD THIS APPLICATION CONDUIT
AND STATE THAT THE ABOVE JS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING
ELECTRICAL WIRING:
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEG OWNER OF THE ABOVE POWER
DESCRIBED RESIDENTIAL. ROP .UTILITY CO.NOTIFIED
SIGNATURE
FINAL
F
OF PERMITTEE
WILLIAM J.FOX.COUNTY ENGINEER VALIDATION 56 8 jUL21 2 1 .2 5 in
6 K,
BY
TY
.Dul
78A683-CEBOd`89\ - Of- i �`
el TLECTRICAL
/'APLC10N FORPERMIT
CNTY'9OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER fBILDING .5-157 f /�J oS�
BUILDING AND SAFETY DIVISION DRESS
JOHN A. LAMBIE, COUNTY ENGINEER ,
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDINGCALITYFOR APPLICANT TO FILL IN AREST •� o�•S Ie v/�"14"
OSS ST.
NO. EACH FEE
RECEIPT. 3 $ ?O $ 60 OWNER
IL
LIGHT TOTAL FIRST 20 •,20 ADDRESSSy- 7 �/ �//J7/�O,f�L'
SWITCH OVER 20 10 CITY XZ-M -KtF �� TEL.NO.
PLAN CHECK
LIGHTING , TOTAL FIRST 20 ,20 2[7 APPLICANT
FIXTURES } OVER 20 ,10 ADDRESS
RANGE_DRYER_WTR. HTR. CITY / /►'��LTEL.NrO.
CONTRACTOR 4 •.�i/7y� S
SPACE HTR DISP.
AIR GOND.A.U. T
ADDRESS � -;-1'. ,- �O03 • cy�•��,•;PO-S-,4 PP
CLOTHES WASH._DISHWASH. CITY /G;r/�LdF G/TT TEL.NO.a.Z- -4)-&l
FAN_OTHER 1.00 LICENSE NO. /'HISS CLASS. C//
MOTORS,TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
IND. HEATERS, ETC. HP. KW. KVA. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
SIZE TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
O - 1 1.00 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATEOF
I - 10 3.00 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO d
RESIDE IN. THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. C
10 — 50 5.00 %//J L
SIGNATURE
50 — 100 10.00 OF PERMITTEE /�
H
100 - 500 15.00 DISTRICT NO. GROUP ZONE PROCESSED BY W
SIGN�,GOATuBR SIGN AND ONE CIRCUIT 3.00 °O� -/ Z
MARQUEE ADDITIONAL CIRCUITS 1.00 NOTESJL
SERVICE NOT OVER 600 VOLTS OR 200 AMP r 2.00 Op
SERVICE OVER 600 VOLTS OR 200 AMP 5.00
TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTORS SIGNATURE
TEMP. POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
WIRING
PERMIT FEE (SUB TOTAL) FIXTURES
PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED
OPF
PERMIT ISSUING FEE 2.00 ,`� UTILITY CO.NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL
L,� �!� JOSEPH C. ROOHAN
TOTAL FEE
i v SUPERVISING ELEC L ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
i Ar,3 7 9 s FEB 2 0 2 D 4.8 0•"
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE IIIc