HomeMy Public PortalAbout9122 PRIMROSE AVE_Electrical__ 78A889-CEBOB 10/74 APPLICA ON ELECTRICAL PERMIT
COUNTY OF LOS ANGELES /
DEPARTMENT OF COUNTY ENGINEER ADOREss C 0 ( oN
BUILDING AND SAFETY DIVISION
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or le a
LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST, ZZ
OUTLETS NO. EACH FEE OWNER OR
FIRM NAME e r
RECEPT._ $ $ MAIL
FIRST 20 25 ADDRESS
LIGHT TOTAL -/�[/
OVER 20 CITY TEL, N T/
SWITCH_ 10 PLAN CHECK
LIGHTING TOTAL
FIRST 20 ,25 APPLICANT If
OVER 20 ADDRESS
FIXTURES .1G
RESIDENTIAL APPLIANCES CITY TEL. NO.
PERMIT
RANGE DRYER_W�TR. APPLICANT
STA. COOK • DISP. F.A.U. ADDRESS / J
SPACE HTR. AIR GOND. CITY TEL. N0.
CLOTHES WASH. 013HWASH. LICENSE OR CLASS.
REG. NUMBER
FAN OTHER 1.00 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING W ITN ALL COUNTY ORDINANCES AND S.TATE LAWS REGULATING
IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING.
912E & TYPE OVER TO
I HEREBY CERTIFY THAT•) AM PROPERLY REGISTERED AND/OR
0 - 1 1.00 LICENSED AS REQUIRED NGELES COUNTY AND STATE OF
CALIFORNIA OR THAI I AM THE FOAL OWNER OR THE ABOVE p„
1 - 10 9.00 DESCRIBED EN OPERT . , C3
PERMITE C4
10 - 50 9.00 SIGNATU r o
50 - 100 10.00 DISTRICT NO. PROCES Y W
[L
100 - 500 15.00 L'-� do coo
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPEC 'S SIGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE
SERVI CENOT OVER 600 VOLTS OR 200 AMP UNDERSLAB WORK
SERVICEOVER 600 VOLTS OR 200AMP 10,00 ROUGH CONDUIT
TEMP SERVICE,POLE,&APPURTENANCES 5.00 WIRING
TEMP LIGHT OR RECEPT. SYSTEM 8.00 FIXTURES
POWER AUTHORIZED
UTILITY CO. NOTIFIED
FINAL s_
PERMIT FEE (SUB TOTAL) 'NOTES:
PLAN CHECK FEE
PERMIT ISSUING FEE 9.00
TOTAL FEE Z d O
PLAN CHECK VALIDATION CK. M.O. CA PERMIT VALIDATION CK. M.0 CA
6 2 12.0 V �-
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SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE