HomeMy Public PortalAbout5164 SERENO DR_Electrical__ /t76A663 CE&06 10,12 APPLICATION FORCE TRI 'AL PERMIT rD -�
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER AORORESs
BUILDING AND SAFETY DIVISION
LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST NL rh OUTLETS NO EACHFEE ,
FO RM NAE 5 S '
RECEPT_ MAIL-
LIGHT
ADDRESS
LIGHT_ TOTAL FIRST 20 'f
0 J _ r ^
I l CITY TEL NO
SWITCH_ OVER 20 l0 � 6 .i�
_ '-PLAN CHECK-
LIGHTING FIRST 20 TOTAL 26 APPLICANT r
ADDRESS
FI%TURES :x OVER 20 10 -
RESIDENTIAL APPLIANCES .
CITY TEL NO
PERMIT
RANGE_DRYER WTR HTR_ 1. APPLICANT
l
STA COOK_DISP A�oF A U _ ADDRESS
F I
SPACE HTR AIR CORD +.� CI TEC NO ,
CLOTHES WASH / DISHWASH ( u REG NUMBER CLASS
FAN_OTHER 100 ' I nEHEBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE Ap DVE IS CORRECT AND AGREE TO COMPLY
MOTOR! TRANSFORMERS RATING WITH ALL COUNTY OR0I NANCES AND STATE LAW! REGULATING
[NO HEATER! ETC HPKW KVA , , ELECTRICAL WIRING
SIZE &JYPE OVER TO ^ ' -
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 — 1 • 100 v'+�' LICENSED AS REQUIRED BY LOS,ANGELE! COUNTY AN
STATE OF
/ CALIFORNIA OR THAT I AM,TME LEO AL NEP OF THE ABOVE �-
1 —`1D 300 u-1 , DPR
EBCRIT ED RE810ENTIAL� OPERTY — W
GI PERMITEE v • ' L
1 10 - 50 SGG SIGNATURE
50 - 100 1000 DISTRICT NO PROC EO BY r2
110
00 - 500 16OD _ ) 1 ' �� 1
SIGN GAS SIGN AND ONE CIRCUIT 5 G APPROVALS DATEF piNECTdYS SHIM,mm W
TUBE OR
MARQUEE ADDITIONAL CIRCUITS IGO TEMP POWER POLE'
SERVI CENOTOVER 600 VOLTS OR�200AMP 300 ,�,� UNDERSLAB WORK -
SERVICEOVER 600 VOLTS OR 200 AMP 1000 ROUGH CONDUIT v _
TEMP SERVICE,POLE &APPURTENANCES 5 G WIRING j
TEMP LIGHT OR RECEPT SYSTEM 3 G FIXTURES
POWER AUTHORIZED -
UTILITY CO NOTIFIED I
W FINAL
PER:CHECK
EE (SUB TOTAL) NOTES •A
PLAFEEPERSUING FEETOEE
PLAN CHECK VALIDATION CK ` M CASH PERMIT VALIDATION CK M 0 CASH
`
26s `L I .0 2 O 3 Q:AJ U amt
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE '
ieAa.$•c¢ea. IG,T. APPLICATION OR EeECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEERioDREssJ4 F
BUILDING AND SAFETY DIVISION 46 0
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
OUTLETS NO EACH I rL OwNER —
FIRM NAME
*FC
_ S S MAIL
L /74
IGHT_ TOTAL
FIRST 20 25 ADDRESS C
44
OVER 20 CITY TEL NO
SWITCH_ 10 PIAN C ECK
LIGI%HTING FIRST 20 y
FTURES 10 APPLICANT
TOTAL
OVER 20 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL NO
PERMIT
RANGE_DRYER_WTR HTR_ APPLICANT
STA COOK_DISP _F A U _ , ADDRESSS /
SPACE HTP AIR CON _ CLIITY TEL,
CLOTHES WASH _DISHWASH _ ho'Nu
ER CLA93 4
FAN—OTHER '
00 I n[R[eY AOKNOWL[UGE THAT I HAVE READ THIS APPLICATION
AND $TATE THAT THE ABOVE ID CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STAT! LAWS REGULATING
IND HEATERS, ETC HP KW KVA ELECTRICAL WIRING
D IZ[ S TYPE OVER TO
HERESY CERTIFY TXBY AM PROPERLY RLOISTERCD AND/011
O — 1 100 LICENSED AS REOUIRED DY LOS ANGELES C TY AX STATS OF ?.
CALIFORNIA OR THAI I AM T L[OAL N R OF E ADOV! S
1 — 10 300 DESCRY[$ RE [NTP IL PR R
PERMITEE
' 10 — 50 6.00 SIGNATURE /
50 — 100 100 N
OISTRIL O PROC SSEO BY
100 - Soo eoo r
SIGN GAS SIGN AND ONE CIRCUIT 500 APPROVAL$ DATE INmrTOII S SIGIMTRS
TUBE OR
MARQUEE ADDITIONAL CIRCUITS IDO TEMP POWER POLE
SERVI CENOT OVER 600 VOLTS OR 2O0 AMP 300 UNDERSLAB WORK
SERVICEOVER 600 VOLTS OR 200 AMP 1000 ROUGH CONDUIT
TEMPSERVICE POLE &APPURTENANCES 500 WIRING
TEMP LIGHT OR RECEPT SYSTEM 30O FIXTURES
POWER AUTHOR IZED I
UTILITY CO NOTIFIED
FINAL
PERMIT FEE (SUB TOTAL) NOTES
PLAN CHECK FEE
PERMIT ISSUING FEE ' 300
TOTAL FEE
PLAN CHECK VALIDATION TO CA5 PERMIT VALIDATION cK M D CASH
477 _r '2-9 2 0 9.00 •
SEE $AM or APPLICATION FOR COMPLETE SCHEDULE