HomeMy Public PortalAbout5431 ROSEMEAD BLVD_Electrical__r
DO S-A 10.41 25M APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY ELECTRIC 1
COUNTY OF LOS ANGELES
WM. J. FOX, CHIEF ENGINEER
Q NAME DISTRICT NO. GROUP I ZONE PERMIT NO.
U ADDRESS
E -
WCITY TEL.NO. RECEIVED BY READY FOR DATE ISSUED
J COUNTY _ �/ 01 FIRST INSPECTION
I
W CERT.NO. EXPIRES
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
JOB
DESCRIPTION OF WORK ADDRESS
NUMBER OF OUTLETS ON CIRCUITS LOCALITY
LOCATION BY ROOMS
NEAREST
LIGHT OUTLETS SW. PLUGS FIXT CROSS ST.
CIRCUIT A 13 1 C D E F G I H d' NAME
Z MAIL
3 ADDRESS
O
CITY TEL.NO.
I AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF QUALIFICATION..
ELECTRICIAN.
1 AM THE I„EGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE
OWNER.
CORRECTIONS
J
— a
Z
O
TOTAL
NO. OF OUTLETS ", $ APPROVALS
NO. OF FIXTURES DATE INSPECTOR'S NAME
NO. OF MOTORS H.P. $ CONDUIT
NO. OF SIGNS TRANS. $ WIRING
NO. OF RANGES OR HEATERS $ FIXTURES
MISCELLANEOUS $ POWER
PERMIT FEE $ UTILITY CO.NOTIFIED
TOTAL FEE s FINAL