HomeMy Public PortalAbout9135 PRIMROSE AVE_Electrical__ '6A683 as a°;R t°'" APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER FADDRESS
BUILDING AND SAFETY DIVISION ` w
FOR APPLICANTTO FILL IN TY �r•
New Residential Bldgs.&Pools EACH NO. FEE CROSST1 &2-Family,Sq.Ft. $ '025 — $ OR e
Multi-family Sq.Ft. 02 — FIRM NAME Nk%Q_%X J
Residential Swimming Pools 25.00 MAIL i
ADDRESS 3.6 PC 12'41. d
Outlets:Rec Light—Sw. CITY--eede 1- Tel.No � �►��
First 20 50 PLAN CHECK
Total No. Additional .30 APPLICANT
ADDRESS
Lighting Fixtures First 20 .50 CITY Tel.No.
Additional .30 PERMIT nn cc
Total.No. APPLICANT I l� • 07 p
Fixed Appliances Not Over 1 HP ADDRESS 9136— eaL
Ronge—Heater_D.W.— CITY 0 1 e 0 Tel.No. 74d'>Z
Oven_Dryer_W.M. LICENSE OR
Top —FAU —W.H._ - REG.NUMBER 0W%e_ .e; Class.
Hood_.'Fan _Other— I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
Disp. — Room Air Cond. 2.50 THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY.WITH ALL COUNTY ORDIN-
ANCES AND STATE LAWS REGULATING ELECTRICAL.WI RING.
Power Apparatus&Large Appliances
Size&Type HP,KW,KVA,or KVAR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT IAM
Up to 1 Incl. 2.50 THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY.
CD
Over 1 to 10 Incl. 5.00 ca
Over 10 to 50 Incl. 12.50 PERMITTEE a:
Over 50 to 100 Inc. 25.00 SIGNATURE
Over 100 40.00 NO. P CESS BY a
Services
0-200 Amp.Under 600 V 12.50 / INSPECTOR'S
201.1000 Amp.Under 600 V 25.00. APPROVALS DATE SIGNATURE
Over 1000 Amp.or Over 600 V 50.00 JDISTRICT
EMP.POWER POLE
Tem Power Pole&A 10.00. EFRE
WORK
Temp. Appurtenances
Sign with One Branch Circuit 10.00 DUIT
2.00
Additional Sign Branch Circuits
Misc.Conduits&Conductors 10.00
Other(See Complete Fee Schedule) HORIZED
NOTIFIEDPERMIT FEE (Sub-.Total).
PLAN CHECKING-FEE (One-Fourth Permit Fee)
PERMIT ISSUING FEE $7.00 e�
TOTAL FEE «
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
.C'
8 9 30APR O
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE r