HomeMy Public PortalAbout5928 ROSEMEAD BLVD_Electrical__ 76AG63-CE806 9-67 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING r a
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY �� L� / /
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
NO. SAC $
FEE OWNER 'gxl6At/ K.ic-
RECEPT._ MAIL•
LIGHT TOTAL FIRST 20 .20 ADDRESS �r� �7 J
SWITCH_ OVER 20 .10 CITY TEL�QNO.)_363l�iE3
LIGHTING ITOTAL FIRST 20 .20 CONTRACTOR gt9-v� 9 •!4 7A' lis&-�-
FIXTURES OVER 20 .10 ADDRES��SQQ-- ��// Lv�� IL J'f/f-
RANGE_DRYER—WTR.HTR.— CITY AP-G, �G��4 TEL. NO. S CI(06 1� I
STA.COOK_DISP.—F.A.U._ LICENSE NO.
SPACE HTR. AIR COND. 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
CLOTHES WASH._DISH WAS H._ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
FA N_O THER 1.00 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
MOTORS,TRANSFORMERS RATING CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
IND. HEATERS, ETC. HP. KW. KVA. RESIDE IN, THE ABOVE DES [BED RESIDENTIAL PROPERTY.
SIZE & TYPE OVER TO SIGNATURE
00,
O - 1 _ 1.00
OF PERMITTEE a
1 - 10 3.00 DISTRICT NO. GROUP ZO P / SED BY 0
10 - 50 5.00
50 - 100 10.00 1 NOTES: // O
100 - 500 15.00 G d
N
SIGN,GAS SIGN AND ONE CIRCUIT 3.00 Z
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 2 F)
SERVICE OVER 600 VOLTS OR 200 AMP 5.00
TEMP SERVICE, POLE, &APPURTENANCES 3.00
APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP. POWER POLE
]UNDERSLAB WORK
ROUGH CONDUIT
ISSUING FEE 2.00
2 IUTILITYCO.NOTIFI
WIRING
FIXTURES
SUPPLEMENTARY ISSUING FEE 1.00 POWER AUTHORIZED
PERMIT FEE ED
PLAN CHECK FEE (50% PERMIT FEE) FINAL_
TOTAL FEE OO JOSEPH C. ROOHAN
SUPERVISING ELECTRICAL ENGI
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.0 CASH
Aoo737� s1 zo 4.00N4
EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
78A663-cE808 9-.64
APPLICATION FOR ELIECTRICAL P MIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEERBUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPT. OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN 4MAII-
AooIL
CROSS ST.
TOTAL OTL r ANO. EACH FE
LIGHT OUTLETS/ FIRST 20 s 20 $ OWNER
10 ADDRESS
SWITCH. OVER 20
1 TOTAL ,-- CITY TEL.NO.
LIGHTING 1 1 FIRST 20 .20
FIXTURES 1 _ ADD'L .10 ELECTRICIAN
OVER 20
RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS
GARB.DISP. , STA.COOK
CITY t f 4EL.NO.
DISHWASH. AUTO.-WASH. STATE
SPACE HTRS. STA.APP.(yA H.P:MAX.) .50 LICENSE NO.
(MOTORS: OVER NOT OVER H.P. DISTRICT NO. GROUP ZONE PROCESSED BY
0 1 1.00 V yu' 7.7-$,
1 3 1.so INSPECTION RECORD
a s 2.00 _ O
S is 2.50 V
18 so 3.00 a
so 100. 5.00 V
NO.TRANS• 4
SIGNS: NO.LAMPS
I Z
SERVICE O-sOOV-NOT OVER 200A 1.00
SERVICE 0-000V-OVER 200 A. 2.00
SERVICE OVER GOOV 5.00
MISC.
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE $ 15 254
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION 'APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL-COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
I HEREBY.CERTIFY THAT 1 AM.PROPERLY REGISTERED AND/CR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN,THE ABOVE WDESCRIEND RESIDEN AL PROPERTY. POWER
SIGNATUREUTILITY CO.NOTIFIED I'
OF PERMITTEE-1FINAL
1111A 716-sf.
LIDATION JOSEPH C. ROOH
CK MO CA9N -SUPERVISING ELECTRICAL ENGINEER
-2 320-
15.
1