HomeMy Public PortalAbout5932 ROSEMEAD BLVD_Electrical__ 7SA563`CESOB 9-64 APPLICATION FOR ELIECTINCAL .PERI�AIT
4 COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS ,s'C
JOHN A. LAMBIE, COUNTY ENGINEER a /�
COLEMAN W. JENKINS, SUPT. OF BUILDING LOCALITY -
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
RECEPT., ' TOTAL + NO. EACH FEE ?
LIGHT OUTLETS FIRST 20 x.20 OWNER -� ad �e i
MAIL
ADD'L ADDRESS {� /,�a� I mse
SWITCH. —+ OVER 20 .10
TOTAL — CITY TEL.NO. r CO$IJ
LIGHTING 1 FIRST 20 .20
FIXTURES 1 ADO'L ,1O ELECTR CIAN
OVER 20
RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS
GARB.DISP. STA.COOK
CITY TEL.NO.
DISHWASH. AUTO.-WASH. STATE
SPACE HTRS. STA.APP.(yA H.P.MAX.) .50 LICENSE NO.
MOTORS: OVER NOT OVER H.P. DISTRICT NO. I GI}OUP O E P ESSED BY
O 1 1.00
o-
I s 11.50 INSPECTION RECORD
a a z.00 �e ,, c �a
s 1s 2.50 2.
f V
-15 so 3.00
O`y,
50 100 5.00 V
SIGN8.t
NO.TRANS. S/2IUL
NO.LAMPS / � �� �`� • Z
SERVICE 0.600V-Nor OVER 200A 1.00
SERVICE 0-600V-OVER 200 A. 2.00
SERVICE OVER 600V 5.00 ( d
MISC.
a�t� s- .��: .'414 _L_r./'
PERMIT ISSUING FEE 2.00 V �~
s
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 41
TOTAL-FEE S
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTO , SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO.COMPLY CONDUIT
WITH ALL COUNTY THE.
AND STATE LAWS, REGULATING
ELECTRICAL WIRING. WIRING
1 HEREBY.CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES O1 A
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF, AND INTEND TO `q' Y T
RESIDE IN,THE ABOVE SCRIBED RESIDENTIA ROPERTY. POWER
SIGNATURE , UTILITY CO.NOTIFIED o ��r`
OF PERMITTEE mmmMFINAL
VALIDA JOSEPH C. ROOHAN
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
Lf1l;o 4 5 9 2`5 AUG 12 2 D ' 8 0,dN c