HomeMy Public PortalAbout5943 ROSEMEAD BLVD_Electrical__ 76A669—CE80610/72 APPLICATION IfOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER FADDRESS
BUILDING AND SAFETY DIVISION
TY
T
FOR APPLICANT TO FILL IN ST.
OUTLETS NO. EACH FEE R i
FI RM NAME
RECEPT. $ $ MAIL �+
LIGHT TOTAL
FIRST 20 25 ADDRESS J�
OVER 20 CITY TEL. �.
SWITCH_ .10 PLAN CHECK
LIGHTINGFI .10
RST 20 .25
FIXTURES APPLICANT
TOTAL
OVER 20 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL. NO.
PERMIT
RANGE DRYER_WTR. HTR. APPLICANT
STA. COOK DISP. F.A.U. ADDRESS Q
SPACE HTR. AIR COND. CITY TEL. NO.3
CLOTHES WASH. OfSHWASH. LICENSE 0
REG. NUMBER ® CLASS. G'
FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND. HEATERS, ETC. HP. KW.KVA. ELE.CTR[CAL WIRING.
S1ZE & TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 — 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF }
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE CL
1 — 1O 3.00 DESCRIBED RESIDENTIAL PROPERTY. p
V
PERMITEE v ,
10 — 50 5.00 SIGNATURE / —v p
F-
50 — 100 toAO W
DISTRICT NO. ROC SED BY CL
100 — 500 15.00 " Q t y
SIGN, GAS =SIGN ONE CIRCUIT 5.00 APPROVALS DATE INSPECTO SSIGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE
S ERVI CE NOT OV ER 600 VOLTS OR 200 AM P 3.00 UNDERSLAB WORK
S ERVI CE OVER 600 VOLTS 0 R 200 AM P 10.00 ROUGH CONDUIT
LEERE,POLE,BcAPPURTENANCES 5.00 WIRING S _? ,/
OR RECEPT. SYSTEM 3.00 FIXTURES
POWER AUTHORIZED
UTILITY CO. NOTIFIED
s
FINAL
(SUB TOTAL) NOTES:
FEE
ING FEE 3.00 3E
PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDA CK. M.O. CASH
0.29tiMAY 16 2 D 6.50AW
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE