HomeMy Public PortalAbout6517 ROSEMEAD BLVD_Electrical__ )eAeea CE iis/ a) APPLICATION FOR ELECTRICAL PERMIT - _
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN
New Residential Bldgs &Pools EACH NO FEE A DRE55 ', ,�/ /
I &2 Family Sq Ft E 025 — f LOCALITY V2M? � B
Multi family Sq Ft' 02 — NEA EST /
Residential Swimmmg Pools 25 00 CROSS ST L/
OWNER OR
FIRM NAME
Outlets RecOLLlght_Sw _ MAIL
First 20 50 AD RE /
Total No AddrHonol 30 CITU Tel No AW1
P HECK
A
Lighting Fixtures First 20 50 ADDRESS
8 Additional 30
Total No CITY Tel No
Fixed Appliances Not Over 1 HP ERMIT
Range—Heater—0 W — APPLICANT
Oven—Dryer_W M_ ADDRESS
Top _FAU — WH — CITY ^ T No '
Hood_Fan —Other— LICENSE OR
Disp _Room A,r Cond 250 REG NUMBER �� Class 4C/60
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA
Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO
Size&Type HP KW KVA ar KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
2 50 REGULATING ELECTRICAL WIRING
Up to 1 Incl I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
Over 1 to 10 IMI 500 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
Over 1010 501nc1 12 50 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE O
25 00 DESCRIBED RESIDENTIA PERTY `
Over 50 to 100 Inc s3r�j
Over 100 4000 _ PERMI7EE
SIGNATURE
Services 111111111
DISTRICT NO E ED BY
0 200 Amp Under 600V 12 50
201 1000 Amp Under 600 V 25 GO . U(J
Over 1000 Amp or Over 600 V 5000 =
Temp Power Pole&Appurtenances 1000 � Q
Sign with One Branch Circuit 1000 Q3�
Additional Sign Branch Circuits 200 INSPECTION
INFORMATION Al 559 A
Misc Conduits&Conductors 1000 ON REVERSE x • • • • • 2
Other(See Complete Fee Schedule)_ SIDE V
2 • • 2200
ee e22005
PERMIT FEE (Sub Total) 13o-78
PLAN CHECKING FEE (One Fourth Permit Feel
PERMIT ISSUING FEE $700
TOTAL FEE Z. >
INSPECTION FINALED \
date /Z 6 2 F/ By IIICCC
16A.6, aC eaeR 10177 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES p�4 P
DEPARTMENT OF COUNTY ENGINEER / SCH�e�O C7
BUILDING AND SAF DIVISION gppDDRE55 -/
PORAPPLI ANTTO FILLIN LOCALITY (4—_ AAA (Y,17-
New Resldenhal Bldgs &Pools EACH NO FEE NtAfthl
1 &2 Family Sq Ft E 025 — S ST A"/O GAL-p.¢�
Multi family Sq k WNEROR
02 — FIRM NAME
Resident,al Swimming Pools 2500 DDRESS ,54
Outlets Ret Light_Sw CITY �7'C, Tel No
First 20 50 PLAN CHLLK
Total No Additional 30 1 APPLICANT
ADDRESS
Lighting Fixtures First 20 50 CITY Tel No
Toro,No
Additional 30 PERMIT
PI / LEL'T
NT l..
Fixed Apphonces Not Over 1 HP ADDRESS S 23�n
Range—Heater—D W _ CITY /0L$ Tel No
Oven _Dryer—W M_ LICENSE OR -
Top —FAU _WH _ REG NUMBER �7o 06 Clow C^ tO
Hood_Fan _Other_ HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICAigN AND STATE
DMP — Room Air Cond 250 THAT THE ABOVE 6 CORRECT AND AGREE i0 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 T i I AM PIIDPERLY RERIMEWTURE
AS
2 r� REQU[RED BY LOS ANGEI AND STATEAM
Up to I Ind 5 DD THE l i V NEED RES
Over 1 to 10 Ind
Over 10 to 50 Intl 1250 PER ITT
14
CD
Over 50 to 100 Inc 2500 SIG
Over 100 4000 DISTRICT NO P
S_ 08tiServices z0 200 Amp Under 600 V 1250 APPROVALS DE
201 1000 Amp Under 600 V 2500
Over 1000 Amp or Over 600 V 5000 TEMP POWER POLE
UNDERSLAB WORK
Temp Power Pole&Appurtenorces 1 000
Sign with One Branch Circuit 1000 ROUGH CONDUIT
Additional Sign Branch Circuits200 IWIRING
Misc Conduits&Conductors 1000 FIXTURES
Other(See Complete Fee Schedule, POWER AUTHORIZED
UTILITY CO NOTIFIED
Ali FINAL
RMIT FEE Sub Total( NOTES or
PLAN CHECKING FEE (One Fourth Permit Fee)
PERMIT ISSUING FEE $700
TOTAL FEE d
PLAN CHECKVALIDATION
n CK M O CASH P®MIT VALIDATION CK M O CASH
.�t_L✓L z<-4i C-t.0 Cc Gi.li[_y-E� t
SRJUN 23 2 0 1 L O °�
SEE BACK OF APPLICATION FOR COMPUTE SCHEDULE
;4A44'C- Ce,e•a I2,75 APPLICATION FOR ELECTRICAL PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT To PILL IN
New Residential Bldgs &Pools EACH NO FEE ADDRESS
007
1 &2 Finaily Sq Ft $ _ $ LOCALITY
MultFfamily Sq Ft _ NEAREST
Residential Swimming Pools CROSS STOWNER OR
FIRM NAME
Outlets Light, Switch& Receptacle MAIL
First 20 ADOR ESS
Additional CITY Tel No
PLAN CHECK
Lighting Fixtures APPLICANT
First 20 ADDRESS
Additional
CITY Tel No
Fixed Appliances Not Over 1 HP PAPPLICANT
ERMIT
Range_ Heater_ DW ADDRESS
Oven _ Dryer W M
Top _ FAU INH CITY Tel No y
Hood FanLICENSE OR
Disp AC REG NUMBE ZQ& Clain
sEY AC.N.EL... THAT I PAYS waw TPIs wPPLIDATI.. p
TO
Power Apparatus& Large Appliances ) STATE THE
NASASAND
AGREE
COMPLY
COUNTY ORDINANCES AND STATE Lww• REGULATING
Size&Type HP, KW, VA or KVAR SL• Twmu VW
wlwlwD a
N
Up to 1 Incl z
T11Y rwA oeew Lr mrt•
Over 1 to 10 Ind uc•P•Sn• Loi w auu c NrY w v TS D
CALIPOR IA :w•D DAL D e AeDYS
Over 10 to 50 Ind .S•.SI
Over 50 to 100 Incl PERM
't AS
Over 100 SIGN TUR
ServiCBs DISTRICT NO SSE Y
0 200 Amp Under 600 V S 08
201 1000 Amp Under 600 V APPROVALS DA INSPECTOR'S
Over 1000 Amp or Over 600 V SIGNATURE
TEMP POWER POLE
Temp Power Pole&Appurtenences LINDE RSLAB WORK
Sign with One Branch Circuit ROUGH CONDUIT
Additional Sign Branch Circuits
( t r) WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FEE (Sub Tota0 UTILITY CO NOTIFIED
PLAN CHECKING FEE (One Fourth Permit Fee) FINAL �1C1"�
PERMIT ISSUING FEE dNOTES
TOTALFEE
/:Z5
LAN CHECK VALIDATION CK MO CASH PERMIT VALIDATIONCK MID CASH
2 1 2PAN 24 2 1 65 0 ABC