HomeMy Public PortalAbout5130 ROSEMEAD BLVD_Electrical__ _
DBS-5A 12-54 A®� q.A •q'.NTOR -ELECTRIC.
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• DIVISION OF' BUILDING AND-SAFETY = =
Department of County -Engineer ,
County of Las Angelesi
;BUILDING
WM. J. FOX, COUNTY ENGINEER ADDRESS
CASSATT:D. GRIFFIN,.SUP'T OF BUILDING - �- -
FORAPPLICANT'T_ O FILL IN '- LOCALITY
PERMIT FEES NEAREST,. ' . ,/
NUMBER EACH
-
-CROSSST
'FEE. � �
LIGHTOUTLETS.` - OWNER
RECEPTACLES - MAIL p -
'ADDRESS
WALL SWITCHES' - r ,.✓
TOTAL OUTLETS l 5! S. - CITY - .TEL NO.
ELEC. RANGES- - 25
ELECTRIC—N`
ELEC. HEATERS - "25ADDRESS 0_' -
..KW EA ' - • CITY `- - - TEL. NO. Dil a•`a� � -(1.
FIXTURES - 5 LICENSE NO.,.
NUMBER OF L16HT CIRCUITS
DIST NO., I GROUP ZO REA Y FOR INSPECTION
NUMBER OF RECEPTACLE CIRCUITS -- '
MOTORS.'
NUMBER,. HORSEPOWER 'FEE INSPE ON' ECORD
NEWMVD. HP OVER "INC. EACH Lt M r-,_T
lh&LESS S. .254-
1h z .56
2 5 .00 It�l'cam i� 1 f�I; ��t l� .f 1:• �I �c�Ail ..
.5 1.5 1.50. .
.. '15, -.., 50 2.50. .....
50 - 200 5.00 - -
NO. SIGNS NO.
TRANS."-, -
_
NO. SIGNS NO. LAMPS ' 2 -
FOR EACH.PERMIT: '•.i -
WIRING .. - .. $1.00 ,..0 0
FIXTURES
• - - $7.00_ . �.V V - .._:- ,.. _.._. ..- .,.
SUPPLEMENTARY :50 -
�qq APPROVALS
TOTAL FEE $ ®1J DATE INSPECTOR'S SIGNATURE
'1 HEREBY ACKNOWLEDGE THAT 1:HAVE READ THIS,'APPLI CATION CONDUIT -
AND STATE'THAT THE, ABOVE, IS'"-CORRECT AND AGREE TO,COMPLY 4 -
WITH' ALL 'COUNTY ORDINANCES AND STATE. LAWS' REGULATING WIRING _
E LECTRICAL'WIRING.:
1 HEREBY CERTIFY" THAT 1..AM PROPERLY'REGISTERED AND/OR FIXTURES '
.LICENSED AS REOUIRED'BYE LOS ANGELES'COUNTY.AND STATE OF '
CALIFORNIA OR THAT 1 AM-THE. LEGAL'OWNER OF THE ABOVE POWER ..• - -
DESCRIBED RESIDENTIAL PROPERTY.. �UTILITY:C O:NOTIFIED. v -
SIGNATURE _
OF PERMITTEE FINAL
'HVILCIAM J:FOX,.CouNTY ENGINEER VALIDATION
i 5Y.8. 1 C . PRAY 3.00
- DEPUTY