HomeMy Public PortalAbout5241 SANTA ANITA AVE_Electrical__ 76A669 CE606 1-68 APPLICATION FOR ELECT IC L PERMI
COUNTX OF LOS ANGELES
DEPARTMENT F COUNTY ENGINEER BUILDING
BUILDING A SAFETY DIVISION ADDRESS ,.Z
JOHN A. LA I , COUNTY ENGINEER.
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDINGLOCALITY NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
NO. EACH FEE
RECEPT.
$ $ OWNER
}� MAIL.
LIGHT TOTAL FIRST 20 .20. // ADDRESS
SWITCH—1- OVER 20 .10 CITY TEL. NO.
.PLAhrCHEeK
LIGHTING TOTAL FIRST 20 .20 1APPLICANT
FIXTURES OVER 20 .10 ADDRESS
RANGE—DRYER—WTR.HTR.— CITY TEL. NO.
STA.COOK_D IS P.LF.A.U.— CONTRACTOR
SPACE HTR. AIR COND. ADDRESS
CLOTHES WASH.—DISHWASH._ }n CITY TEL. NO. -
FAN�OTHER 1.00 ��/ LICENSE NO.. „i! CLASS. �/Q
MOTORS,TRANSFORMERS RATING
IND'. HEATERS, ETC. HP. KW. KVA. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE 8: TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO'COMPLY'
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
E.LECTR[CAL WIRING.
0 - 1 1.00
1 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 I AM THE LEGAL OWNER OF, AND INTEND TO
10 - 5o 5.00 RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. O
50 - 100 1.0.00 SIGNATURE V
OF PERMITTEE D:
100 — 500 1s.00 DIST. IC G UP Z E 0
SIGN,GAS SIGN AND.ONE.CIRCUIT 3.00 W
TUBE, OR IL
MARQUEE ADDITIONAL CIRCUITS 1.001 NOTES: Z
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2..00
SERVICE OVER 600 VOLTS OR 200 AMP 5.00
TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP. POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT G
PERMIT FEE (SU•B TOTAL) WIRING
FIXTURES
PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED
PERMIT ISSUING FEE 2.00 UTI LI TYCO.NOTIFIED
,
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL
TOTAL FEED J SEP C. ROOHAN
SUPERVISING ELECT ICAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASs+ PERMIT VALIDATION CK. M.O. CASH
LL,0 4 1 8 9ti; APR 8 2 D ^'
'E BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE ��
DEPARTMENT OF BUILDING AND 0+'ETY dwrsimA Amyri impim JL A2&UTAAA
COUNTY OF LOS ANGELES ELECTRIC
WK. J. FOX CHIEF ENGINEER/
S NAMEy'' �'li �`` ' DISTRICT NO. GROUP ZONE PERMIT NO.
ADDRESS dS It /Ii'Z/f1.1� Ix''141i ✓ /,! /
t� "Tit, �J.gI�, RECEIVED BY READY FOR DATE ISSUED
CITY �d�f•JJJ`fl.� TEL.NO.•• ...7r�`v' , -4 'FIRST INSPECTION
COUNTY p� pp�� Al {/ v l
CERT.NO. ds! Y C]/ / EXPIRES i/1 l�A-0/.!•. '' Y
APPLICANT_ FHd IN T$EAVILY O'[WNfjE/D�PORTION ONLY
DESCRIPTION OF WORK ADDRESS
NUMBER OF OUTLETS ON CIRCUITS LOCALITYLOCATION BY `
LIGHTROOMS
OUTLETS SW. PLUGS Fair C 8T ////jk` +✓fyy� a/�^
CIRCUIT '. A113 CID E F IG H N NAME
y�s /J 1 Z MAIL
ADDRESS A" �!/PJf /
CITY Z_0 1,,L T-�F./l
11FI AM THE LEGAL POSSESSOit OF THE ABOVE LOS
ANORLSO COUNTY CERTIFI T OF UAL•IFICAT ON..
�r ELECTRICIAN.
l�U iri 1 i AM THE LROAL OWNER OF'fH6 PROPQ:RTY DESCRIBED
ABOVE
OWNER.
CORREMONS
,O�Z/Crim �A��0F}ff!
J
Q
Z
m
- R
O
s
Y
TOTAL /O • _
NO. OF OUTLETS $ ' APPROVALS
OF FIXTURES _) y
N
41 DATE INSPECTORS NAME
NO. OF MOTORS HP. 'CONDUIT
NO. OR SIGNS TRANS. ffi WIRING
NO. OF RANGES OR HEATERS FIXTURES
MISCELLANEOUS $ POWER
PERMIT FEE E l 4S UTILITY CO.NOTIFIED •�. 4
TOTAL FEE �'� �n. D FINAL