HomeMy Public PortalAbout5110 1/2 SERENO DR_Electrical__ III'A APPLICATION FOR ELECTRIC PERMIT I
DIMON OF BUMDING AND SAFETY
DepaTtmsat of County Engines: -- -
County�of Los An9sin 'EMU58sereno
WM J FOX COUNTY ENGINEER
CAPoATT D GRIFFIN SUP T of BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PERMIT FUS CROSS ST
NUMBER EACH FEfi
OWNER mallgAr
LIGHT OUTLETS
RECEPTACLES MAIL
ADDRESS -
WALL SW ITCHES
TOTALOUTLETS 5f ! 1 CI r
ELEC RANGES zs ELECTRICIAN E- rgrbin
_ELEC HEATERS ZD ADDRESS
11900 S- rurtlq AvA -
KWEA CITY Alhnynhra TEL NO
FIXTURES D ICE SE NO
NUMBER OF LIGHT CIRCUITS DISTRISCT IrfO I G�eP x0 E RADT FOR INSPECTION
NUMBER OF RECEPTACLE CIRCUITS
MOTORS
nUMEER HORSEPOWER FEE INSPECTION RECORD
NEW NVO HP OVER INC EACH `
Yl•LRAI 25
2 DO
2 D 100
D ID 1 Do
fs Do 230
so 200 500
MISC
NO SIGNS NO TRANS
NO SIGNS NO LAMPS
FOR EACH PERMIT
WIRING $100
FIXTURES Sf 00
SUPPLEMENTARY DO APPROVALS
_ TOTAL FEE DATE INSPECTOR SSIGNATURE
1 HEREBY ACKNOWLEDGE THAT 1HAVE READ THIS APP O CONDUIT'
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COYPU
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING 0n -
ELECTRICAL WIRING _
1 HEREBY CERTIFY THAT 1 AY P G PED AND/OR FIXTURES
LICENSED AS REQUIRED SY LOS S COU ND STATE OF
CALIFORNIA OR THAT 1 AY OW OF THE ABOVE POWER
DESCRIBED RESIDENTIAL P
SIGNATURE UTILITY CO NOTIFIED
OF PERMITT FINAL 4
WILLIAM J FOX.COON ENGINSSR VAL AAnON A C VEIT•CHIEF ELXC INSIFECTOR
jAC�4 8 5 6 A APR 9 2 390 0