HomeMy Public PortalAbout5215 SANTA ANITA AVE_Electrical__ DOS-SA 9•BS 9
DAPPLICATION FOR ELECTRIC PERMIT �.
BS•
(DIVISION OF BUILDING AND SAFETY
{ Deportment of County Engineer
County of Los Angeles BUILDING
WM.J.FOX.COUNTY ENGINEER ADDRESS
CASSATT D.GRIFFIN.SUPT OF BUILDING .
LOCALITY
FOR APPLICANT TO FILL IN NEAREST f
PERMIT FRES CROSS ST.
NUMBER EACH FEE
LIGHT OUTLETS ' OWNER
RECEPTACLES MAIL
ADDRESS
WALL SWITCHES
TOTAL OUTLETS CITY TEL.NO.
ELEC.RANGES 25 ELECTRICIAN
_ELEC. HEATERS 25 ADDRESS
KW EA CITY X. TEL. est
FIXTURES 5 LICENSE NO.
NUMBER OF LIGHT CIRCUITS - DISTRICT NO. GROUPMZNIREADY FOR INSPECTION
NUMBER OF RECEPTACLE CIRCUITS s- IdMOTORS "III
NUMBERHORSEPOWER FEE SPECTION ORD
NEW MVD. HP OVER INC. EACHt.�. +
V2&LESS $ .25
2 2 .50
2 5 1.00
5 15 1 1.50 Akd1+ ee �'��•'
15 50 2.50
50 200 5.00
MISC.
NO.SIGNS NO.TRANS.
NO.SIGNS NO.LAMPS
FOR EACH PERMIT:
WIRING $1.00
FIXTURES $1.00
SUPPLEMENTARY .50 APPROVALS
TOTAL FEE $ DATE INSPECTOR'S SIGNATURE
1 HEREBY ACKNOWLEDGE THAT I 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
ELECTRICAL WIRING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE POWER
DESCRIBED RESIDENTIA R RTY.
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITTEE FINAL v ®
WILLIAM J.FOX.COUNTY ENGINEER VALIDATION A.C.VEIT.CHIEF ELECT.INSPECTOR
IP-5 7 2 ON mAy 4' 2 3.6 5 .`�