HomeMy Public PortalAbout6243 ROSEMEAD BLVD_Electrical__ 76A683-CE806 10/74 APPLICATION R E'L_iaiiCAL PERM
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER ppoREss Ips+ rrJf�L) '�vd ,
BUILDING AND SAFETY DIVISION
LOCALITY
NEAREST J
FOR APPLICANT TO FILL IN CROSS ST.
OUTLETS tNO. EACN FEE7 OWNER ORCApmr �L
FIRM NAME , + �G RECEPT. $ $ MAIL SLIGHT TOTAL FIRST 20CITY j1�/'/�L L'" / TEL. N0. ZS6,"SWITCH OVER 20 ipPLAN CHECK
LIGHTING 1 FIRST 20 2 APPLICANT
)} TOTAL
OVER 20 ADDRESS
FIXTURES 1p
RESIDENTIAL APPLIANCES CITY TEL. NO.
PERMIT r1, C ���L� ELE2XC
, &
RANGE DRYER_WTR. HTR. APPLICANT ll V ,�
STA. COOK DISP. F.A.U. ADDRESS Z Z �L/! "//b9oo
SPACE HTR. AIR COND. CI TY ',` g/ TEL. N0.�j'-/
CLOTHES WASH. DISHWASH. REG NSE OR /xv CLAS
FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING.
SIZE B TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 - 1 1.00 LICENSED AS REOU IRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAI' I AM THE LEGAL OWNER OF THE •ABOVE
I - 10 3.00 DESCRIBED RES IDENNTT.AL PROPERTY. ////////�� / C7
PERMITEE ZA" L i L_ F-
10 - 50 5.00 SIGNATURE f sL C3
V
50 - 100 10.00 DISTRICT N0. UCEVED BY H
100 - 500 15.00 G Z
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTO16 SIGNATURE
TUBE, OR
MARQUEE ADDITIOt AL CIRCUITS 1.00 TEMP. POWER POLE
SERVICENOTOVER600VOLTSOR200AMP 3.00 UNDERSLAB WORK
SERVICEOVER 600 VOLTS OR 200AMP 10.00 ROUGH CONDUIT
TEMP SERVICE,POLE,&APPURTENANCES 5.00 WIRING
TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES
POWER AUTHORIZED �-7
UTILITY CO. NOTIFIED +e
FINAL go "?d
PERMIT FEE (SUB TOTAL) NOTES: r
PLAN CHECK FEE W 7* 6—r
PERMIT ISSUING FEE 3.00• �.7 D f ry
TOTAL FEE 21. U
PLAN CHECK VALIDATION CK. M.6. CASH PERMIT VALIDATION CK. O. CASH
9 2 1; tr11 229 2 U
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 1
16/669 C6 ek6R` I77AP•PLI•CATI N FO L � TRIC ERMIT I
COUNTY OF LOS ANGELES
;± DEPARTMENT OF COUNTY ENGINEER ADDRESS I' A
BUILDING AND SAFETY'DIVISION
FORAPPLICANTTO FILL IN LOCALITY 07 14 C11
New Residential Bldgs.&Pools EACH NO. FEE RT.
1 &2-Family,Sq.Ft. COSSS
$ '025 — $ OWNER T pp '
Multi-family Sq.Ft. .02 — FIRM NAME. Cl -e-
Residential Swimming Pools 25.00 MAIL
ADDRESS 4 243
I?d
Outlets:RecLight_Sw. CITY e , � Tel.No. 11 d
First 20 •50 PLAN CHECK
Total No. Additional .30 APPLICANT
ADDRESS
Lighting Fixtures First 20 .50 CITY Tel.No.
IT
Total No. Additional 30 APPLICANT Wil Ck-be
Fixed Appliances Not Over 1 HP• ADDRESS G /ZY3
Range_Heater D.W._ CITY �p. Tel.No.
Oven_Dryer_W:M._ LICENSE OR
Top —FAU —W.H.— REG.NUMBER Class.
Hood_Fan _Other- I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
Disp. —Room Air Cond. 2.50 1 THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDIN-
ANCES AND STATE LAWS REGULATING ELECTRICAL WIRING.
Power Apparatus&Large Appliances
Size&Type HP,KW,KVA,or KVAR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS
REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM
Up to 1 Incl. 2'50 THE LEGAL OWNER OF'THEABOVED CRIBED RESIDENTIAL PROPERTY.
• o
Over 1 to 101ncl. 5.00 ca
Over 10 to 50 Incl. 12.50 PERMITTEE o
Over 50 to 100 Inc. 25.00 SIGNATURES t3
Over 100 40.00 DISTRICT NO 0ES D BY Z
Services
0-200 Amp.Under 600 V 12.50 INSBECTOR'S
20.1-1000 Amp.Under 600 V 25.00 APPROVALS DATE SIGNATURE
Over 1000 Amp.or Over 600 V 50.00 TEMP.POWER POLE
Temp.Power Pole&Appurtenances
10.00 UNDERSLAB WORK
Sign with One Branch Circuit 10.00 ROUGH CONDUIT
2.00. WIRING
Additional Sign Branch Circuits
Misc.Conduits&Conductors 10.00 FIXTURES
Other(See Complete Feb Schedule) POWER AUTHORIZED
UTILITY CO.NOTIFIED
FINAL
PERMIT FEE (Sub-Total) NOTES
PLAN CHECKING FEE (One-Fourth Permit Feel
,PERMIT ISSUING FEE $7:00
TOTAL FEE
PLAN CHECK VALIDATION CK. M.O.. CASH PERMIT VALIDATION < CK. M.O. CASH
19 3 to-APR za 2 0 l oz o Aw
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE