HomeMy Public PortalAbout4957 SERENO DR_Electrical__ Tenee:-cEeoa 6 1 `APPLICATION FOR ELECTRICAL�PEWIT _ IJ
COUNTY OF LOS ANGELES
' DEPARTMENT OF COUNTY ENGINEER BUILDI s S �Qyl7(f
BUILDING AND SAFETY DIVISION
LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS 3T
OUTLETS OWNER
RECEPT 12. $
MAIL
LIGHT TOTAL FIRST 20 b ADDRESS
44
CITY TEL NO
SWITCH OVER 20 t0 qs-
PLAN
LIGHTING FIRST 20 [y
FIXTURES APPLICANT
TOTAL
OVER 20 ADDRESS
10
RESIDENTIAL APPLIANCES CITY TEL No
RANGE DRYER ER_WTR HTR_ PERM
APPLICANT
STA COOK_DISP _F A U _ ADDRESS
SPACE HTR AIR CORD_/— CI Ty
TEL NO
CLOTHES WASH DISHWASH �'
�../� LICENSE NO CLASS
FANOTHER 100 / (1(J I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AMD STAT[ THAT THE ABOVE Ip CORRECT AND ABR[[ TO COMPLY
MOTORS TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STAT[ LAWS REGULATING
IND HEATERS [TC HP KW RVA ELECTRICAL WIRING
BIZ! B TYPE OVl: TO
I NSR[BT CERTIFY REOUIR THAT I AM PROPERLY R[SIp AND
AND/OR
Q - 1 IOD CALIFORNIALICENSEDAS RTHATIO BY HE ANGELES COUNTY 1N0 TAT[ GF
CALIFORNOR THAT AM THE LEGAL OWN OF, 0 TEND TO O
1 - 1Q 300 RESIDE IN THE A K
[ DES IpED !N L RORTY
U
SIGNATURE
10 - SO 500 OF PERM I TT O
60 - 100 1000
OISTR TNO CLASS ZONE "ED BY
100 - 600 1500 G PRh/ d
N
SIGN GAS SIGN AND ONE CIRCUIT 500 NOTES ?
TUBE OR
MARQUEE AD0I TIQNAL CIRCUITS 100
SERVI CENOTOVER 600 VOLTS OR 200 AMP 300
SERVICEOVER 600 VOLTS OR 200 AMP 10110 APPROVALS DATE WSPECTCIPS SIIAATUIRIE
TEMP POWER POLE
TEMPSERVICE POLE B APPURTENANCES SOD
TEMP LIGHT OR RECEPT SYSTEM 300 UNDERSLAB WORK
ROUGH CONDIUT
WIRING
FIXTURES
/ POWER AUTHORIZED
PERMIT FEE (SUB TOTAL)
UTILITY CO NOTIFIED
PLAN CHICK FEE
PERMIT ISSUING FEE FINAL
300
TOTAL FEE
PLAN CHECK VALIDATION CK M 0 CASH PE ij IT VALIDATION cK M o CASH
pr 1 5 4 6731 JUN g 2 0 14.00—
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1
SEE SAM OF APPLICATION FOR COMPLETE SCHEDULE
76A663-CE506 3.09
- APPLICATION FOR ELECTRICAL PERMIT
.� COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER rLOx7CALl7TYT7'—t5A_41>/,—
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BUILDING AND SAFETY DIVISION
4 OR
JOHN A LAMBIE, COUNTY ENGINEER
COLEMAN W JENKINS, SUPERINTENDENT OF BUILDING
FOR APPLICANT TO FILL IN NEAREST fes"
CROSS ST G
NO EACH FC(
RECEIPT f OWNER `
ADDRESS �,J
LIGHT 07 4FEXzIZmIAm71
TOTAL FIRST 20 Ze> 20 007
SWITCH 32OVER 20 10 O CITY TEL NO
PLAN CHECK It iAPF
LIGHTING TOTAL FIRST 20 20 APPLICANT
FIXTURES � Ile OVER 20 i0 ADDRESS
RANGE_ORYER WTR HTR CITY j TEL NO
STA COOK_DISP _F A U CONTRACTOd.L6 /
SPACE HTR —AIR COND ADDRESS
CLOTHES WASH DISHWASH � CITY TEL NO
FAN--OTHER 3 1 DO (/y LICENSE NO CLASS
MOTORS TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
IND HEATERS ETC HP KW KVA AND STAT( THAT THE ABOVE I5 CORRECT AND
AGREE TO COMPLY
S12E Q TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING
0 — 1 1 GO I HERESY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
JCENSED A5 REOUIRED BY Los ANGELES COUNTY AND 5TATEOF
1 — 10 3 00 cALI FO RNu ON
THAT I AM THE LEGAL OWNER OF AND INTEND TO
RESIDE IN THE ABOVE DESCRIBED RESIDE N AL P OP TY O
10 — 50 5 DO V
SIGNATURE DEC
50 — 100 10DO OF PERMITTE O
100 — 500 500 DIaTR No GROUP z • aa(D E _ W
SIGN,GAS SIGN AND ONE CIRCUIT 3 00 � 1C�LSW
TUBE, OR Z
MARQUEE ADDITIONAL CIRCUITS 1 00 NOTES
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00 aw
SERVICE OVER 600 VOLTS OR 200 AMP 5 00
TEMP SERVICE, POLE, &APPURTENANCES 3 DO APPROVALS DATE elsPccTm'S awMTLwe
TEMP POWER POLE
JA
NDERSLAB WORK
OUGH CONDUIT
IRING
PERMIT FEE (SUB TOTAL) FIXTURES
Pz
PLAN CHECK FEE (50'A PERMIT FEE) OWER AUTHORIZED
PERMIT ISSUING FEE 2 00 cc UTILITY CO NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL
TOTAL FEE JOSEPH C ROOHAN
SUPERVISING ELECTPJF
QAL ENGINEER
PLAN CHECK VALIDATION _ ER M 0 = CASH PERMIT VALIDATION cK M o CASH
i cr s a a 3� SE322 2 0 ; ,1, 4.6QY
SCE BACK OF APPLICATION FOR COMPLFTF RFE TCMFDIILF
APPLICATION FOR ELECTRIC P RMIT 1
COUNTY OF LOB ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE. COUNTY ENGINEER
CASSATT D GRIFPIN BUP'T OF BUILDING LOCALITY '
FOR APPLICANT TO FILL IN NEAREST /
PERNIIT F= CROSS ST
1 T E Y
NUMBER EACH PEE OWNER
OUTLET /� MAIL
LIGHTS R¢CEFT .
` 10 s 20 ADDRESS
LIGHTING FIXTURES to CITY e06TEL.No S
E.EC RANDEI "0 D"MRIE ELI RICIA
WATER HEATERS 30 ADDRESS
F^ SPACE HTAA DIEHWASHEla CITY TEL O
GAR¢Ao¢DIEPOSEre AUTO-
STATE l 6 S'9
WASHERS STA COOKING UNITS 23 LICENH O
MOTORS OVER INC HP �1 DIS R
O— yE 25
2 so RIiSPECTION RECORD
2— a loo
a— 1a too
Is— BO 200
BO-200 Boo
SIGNS NO TRARIII
NO LAMS
SERVICE 0.600V 100
SERVICE OVER SOOV 500
MISC.
WIRING PERMIT too
FIXTURE PERMIT 100
SUPPLEMENTARY PERMIT 50
TOTAL FEE •
1 H[RIDY ACIOIOWLEDGe THAT I HAVE READ THIS ICATIOH APPROVALS DA= IIOPECTOwa D1GNATUw6
AND ETATe THAT THE ABOVE la CORRECT AND AGREE TO COMELY
WITH ALL COUNTY OROINANCEY Alm STATE "" REGULATING CONDUIT
EdCTRIG WIRING WIRING 1 j
1 HERESY CERTIFY THAT 1 AM PROPERLY REGISTERED AKD/OR
LICENZzG AB REQUIRED BY LOG ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF ASOVS
DEaCR1aw R PENTIAL PROPERTY WER
SIGNATURE UTILITYCO NOTIFIED /
OF PERM[
F
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