HomeMy Public PortalAbout5728 ROWLAND AVE_Electrical__ 76AGGS
DBS-SA
8•SS APPLICATION FOR ELECTRIC PERMIT
D
DIVISION OF BUILDING AND SAFETY
Deportment of County Engineer
County of Los Angeles BUtLDtWG
WM.J.FOX,COUNTY ENGINEER ADDRESS
CASSATT D.GRIFFIN.SUP'T OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST ` �'
PERMIT FEES CROSS ST. ( ,
NUMBER EACH FEE
OWNER
LIGHT OUTLETS.
MAIL
RECEPTACLES ADDRESS
WALL SWITCHES
TOTAL OUTLETS S+ 5¢ $ CITY TEL.NO..
p ELEC.RANGES 25 .$� ELECTRICIAN O.
?_ELEC. HEATERS 23 ADDRESS S d S
KW EA CITY TEL.N
FIXTURES 5 .LICENSE NO.
NUMBER OF LIGHT CIRCUITS
DISTRICT NO. .I GROUP i ZON E I READY FOR INSPECTION
`+ NUMBER OF RECEPTACLE CIRCUITS E
MOTORS
M1 NUMBER HORSEPOWER FEE INSPECTION RECORD
' NEW MVD. HP OVER INC. EACH /
116 @ LESS $ .25 �✓1`••-�i�C.. G G'�w` L...�• r„�'� F —1
2 .50
2 5 1.00 --
5 15 1.50 , Z2 �
a
1.5 50 2.50
50 200 5.00
i
MISC.
NO.SIGNS NO.TRANS.
NO.SIGNS NO.LAMPS
FOR EACH PERM IT:
WIRING
FIXTURES v-001
SUPPLEMENTARY .50 APPROVALS.
TOTAL FEE S V DATE INSPECTORS SIGNATURE
I HEREBY ACKNOWLEDGE THAT 1 HAVE.'READ THIS APPLICATION CONDUIT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING
f, ELECTRICAL WIRING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND. STATE OF A
CALIFORNIA OR THAT I E EGA WNER OF THE ABOVE POWER 1\
DESCRIBED RESIDENTIA R P i
SIGNATURE' UTILITY CO.NOTIFIED IiT1095
OF PERMITTEE FINAL
WILLIAM J.-FOX.COUNTY ENGINEER VALIDATION A.C.VE1T.CHIEF ELECT.INSPECTOR
moo-8 12 S. DEC 13 2 . 3,8 0 in