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79y16834406 468 APPLICATION FOR ELECTRI AL PERM
pr
r COUNTY OF LOS ANGELES
r DEPARTMENT OF COUNTY ENGINEER
FBBUILDING AND SAFETY DIVISION SS ,JOHN A. LAMBIE. COUNTY ENGINEERCOLEMAN W. JENKINS, SUPERINTENDENT OF BUILDINGITYST
FOR APPLICANT TO FILL IN ST
NO. AC . FEE
S S RECEPT._LIGHT TOTAL FIRST 20 .20 SS ` Ar
-
SWITCH_ OVER 20 .10 CITY TEL. NO.
PLAN CHECK
LIGHTING ITOTAL FIRST 20 .20 APPLICANTFIXTURES OVER 20 .10 ADDRESS
RANGE—DRYER—WTR.HTR.—
CITY O. Qr�LJ
STA.COOK_DISP'.—F.A.U._ CONTRACTOR
SPACE HTR. AIR COND. ADDRESS
CLOTHES WASH._DISHWASH._ CITY . NO. 747
FAN—OTHER 1.00 LICENSE WO. S,-ZV CLASS.
MOTORS,TRANSFORMERS RATING
IND. HEATERS, ETC. HP. KW'. KVA. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS. CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
0 - 1 1.00
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
1 - 10 3.00 LICENSED AS RED UI D BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THA AM THE LEGAL OWNER OF, AND INTEND TO
10 - 50 1 5.00 RESIDE IN, THE OVE DES. IB D RESIDENTI PR PERTY.
50 - 100 10.00 SIGNATURE Dom.
OF PERMITT V
100 — soo 15.00 DISTRICT N GROUP ZONE P D
� o
SIGN,GAS
TUBE, OR SIGH AND ONE CIRCUIT 3.00 V
MARQUEE CL
ADDITIONAL CIRCUITS 1.00NOTES• D_
y
Z
SERVICE NOT OVER 600 VOLTS 00 AMP 2.00
SERVICE OVER 600 VOLTS OR 200 AMP 5.00
1
115
TEMP SERVICE, POLE. &APPURTENANCEjf 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP..POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
PERMIT FEE (SUB TOTAL) WIRING
FIXTURES
PLAN CHECK FEE (50°k PERMIT FEE) POWER AUTHORIZED /
PERMIT ISSUING FEE 2.00 UTILITYCO.NOTIFIED '�(� �,.s��
SUPPLEMENTARY PERMIT ISSUING FEEI 1.00 FINAL
TOTAL FEE JOSEPH C. ROOHAN
SUPERVISING ELECTRICAL-ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION cK. M.O. CASH
LAC
.3 6 6 7 3 APR 3 0 2 0 L,.U �' "a'
r
EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
'76A66 a CE606 468 APPLICATION FOR ELECTRICAL PERMIT
"'COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER rADDRESS
UILDING
BUILDING AND SAFETY DIVISION JOHN A. LAMBIE, COUNTY ENGINEERCOLEMAN W. JENKINS, SUPERINTENDENT OF BUILDINGOCALITY �/+• pp T •• /�
FOR APPLICANT TO FILL IN
CROSS ST. (;-.C A ,J Ata
NO. AC FEE
RECEPT._
s s OWNER ,7!LA l•J MAIL
LIGHT TOTAL FIRST 20 .20 ADDRESS <2v43 • N . VKea.w
SWITCH_ OVER 20 .10 CITY �'� TEL. NO.
PLAN CHECK
LIGHTING FIRST 20 .20 APPLICANT
FIXTURES ITOTAL
•OVER 20 .10 ADDRESS
RANGE_DRYER—WTR.HTR._ CITY MOTEL. NO.
STA.COOK_DISP._F.A.U._ CONTRACTOR 9Q\W �,
SPACE HTR. AIR CO.ND. ADDRESS u all ` Sd 01'O
CLOTHES WASH._DISHWASH._ CITY �� W dCi TEL. NO.UZ,a X
FAN—OTHER 1.00 LICENSE IJO. •�Z10 CLASS. C- ft*
MOTORS,TRANSFORMERS RATING 7Z
IND. HEATERS„ ETC. HP. KW. KVA. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
0 - 1 1.00 ELECTRICAL WIRING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
1 - 10 3.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF, AND INTEND TO
10 - 50 5.00 RESIDE N, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY.
50 - 10010.00 SIGNATURE �/j n y a p�
OF PERMITTEE �-�+c^+- V'
100 - soo 15.00 DIS , I� NO. G UP E BY o
TUBE,GAS SIGN AND ONE CIRCUIT 3.00 (y �
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 a
NOTES: y
SERVICE NOT OVER 600 VOLTS OR 200 AMP 12.00
SERVICE OVER 600 VOLTS OR 200 AMP 5.00
TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE
kq.g
TEMP.'POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
,PERMIT FEE (SUB TOTAL) WIRING
FIXTURES
PLAN CHECK FEE (50%. PERMIT FEE)
POWER AUTHORIZED
PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED `
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL
TOTAL FEE 6 40 JOSEPH C. ROOHAN
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION (::�� M.O. CASH
8 4 4 4 6 FEB 17 2 D 2.40
M BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE