HomeMy Public PortalAbout5837 TREE ROSE TER_Electrical__ 76AOGS-CE906 9-67 APPLICATION FOR ELECTRICAL PERMIT/9f I
`fl
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER eu1Lo1NG
BUILDING AND SAFETY DIVISION Lot 2 ADOREss 58 37 N. Tree Rose
JOHN A LAMBIE COUNTY ENGINEER l�
COLEMAN W JENKINS, SUPIKRINTIENDIENTOFBUILDING LOCALITY San Q
NEAREST
rabriel
FOR APPLICANT TO PILL IN C5055 ST H@j'IDOB$ St
NO FL
PT
73 A
5 OWNER
MAIL
��/� TOTAL FIRST 20 20 `� ADDRESS Te e C Blv
H%/V OVER20 10 0 CITY TEL NOING iTOTAL FIRST20 20 Q CONTRACTOR
FIXTURES /! // OVER 20 10 ADDRESS 11126 Concertst.
RANGE—DRYER{..—WTR HTR CITY TEL NO
STA COO K./�(_DISP �F A U � LICENSE NO
SPACE HTR. -AIR CONS HEREBY ACKNOWLEDGE THAT HAVE READ THIS ARLI CAT I ON
AND STATE THAT Tf ASOV[ Il CORRECT AND AGREE TO COMPLY
CLOTHES WASH D SH WASH L WITH ALL COUNTY ORDINANCES AND STAT[ LAWS REGULATING
ELECTRICAL WIRING
FA N_OTHER 1 00 1 HERESY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
MOTORS TRANSFORMERS RATING LICENSED Al REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT IAM THE LEGAL OWNER OF AMO INTEND TO
IND HEATERS ETC HP KW KVA RESIDE Ix TNf ABOVE p SCRIBE RESIOCNTIA R PEATY
SIZE h TYPE OVER TO
SIGNATURE
0 - 1 1 00 OF PERMITTE
1 - 10 3 00 yIP E PR ESSED BY UU
10 so 5 00 — m
50 - 100 1000 100 - 500 1500SIGN GAS SIGN AND ONE CIRCUIT 3 00TUBE ORMARQUEE ADDITIONAL CIRCUITS 100SERVICE NOT OVER BOO VOLTS OR 200 AMP 2 00 JINOTES
SERVICE OVER 500 VOLTS OR 200 AMP 5 DOTEMP SERVICE POLE 6 APPURTENANCES 3 00
DATE INSPECTORSBIGN4IRIE
TEMP POWER POLE
J� ROUGH
DERSLAB WORK
CONDUIT
RING
ISSUING FEE 2 00
TURESSUPPLEMENTARY ISSUING FEE 1 00WER AUTHORIZED
PERMIT FEE ILITY CO NOTIFIEOI —PLAN CHECK FEE (50% PERMIT FEE) AL
TOTAL FEE JOSEPH C ROOHAN
SUPERVISING ELECT ICAL ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M o CASH
Lko 6278.2 SEP 5 2 A 8.10~ U
IEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
',GAGS' "806 11-71 APPLICATION FOR ELECTRICAL PERMIT LJ
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
OUTLETS NO EAU FEE OWNER
RECEPT_ $ $ MAIL
LIGHT_ TOTAL FIRST 20 AGGRESS �3V
OVER 20 CI Y /
SWITCH_ IO PLAN CHECK
LIGHTING TOTAL FIRST 20 2S APPLICANT
FI%TURES ID
OVER 20 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL NO
PERMIT
RANGE_DRYER_WTR HTR_ APPLICANT 7R!y
STA COOK_DISP F A U _ ADDRESS Sot
SPACE HTR AIR COND Cl TV v TEL NO
CLOTHES WASH DISHWASH_ LICENSE NO 'lS.f'U CLASS eZe
FAN_OTHERlOD I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STAT! THAT THE ABOVE Ie CORRECT AND AGREE TO COMPLY
MOTOR/ TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STAT! LAWS REGULATING
IND HEATERS ETC HP KW KVA ELECTRICAL WIRING
SIZE . TYPE OVER To
NSEDRA CERTIFYIR THAT AM GE PROPERLY REGIS TER[0 ANO/OR
O — 1 100 CALIFORNIARAS REQUIRED BY LO/LEGAL
OW COUNTY AND STATE OP
CALIFNOR THA AM THE LEGAL OWNER KN AND INTEND TO
��.-yJ 1 — 10 n00 —� RESIDE IN, TX • V DfSCP f0 R[/IOL MT AL PROPERTY 0
10 — SO 500 SIGNATURE K
OF FERMI O
60 - 100 IODO r
DurRlcr no none zo PRO13.10 /T
100 - Soo 11300 _1 H
SIGN GAS SIGN AND ONE CIRCUIT SOO NOTES ?
TUBE OR
MARQUEE ADDITIONAL CIRCUITS IDO
SERVICENOTOVER 600 VOLTS OR 200AMP 000
S ERVI CE OVER 600 VOLTS OR 200 AM P 1000
APPROVALS DAT[ t@KTOIHl SIGNATURE
TEMP POWER POLE
TEMP SERVICE,POLE, C APPURTENANCES 500
UNDERSLAB WORK
TEMP LIGHT OR RECEPT SYSTEM 900
ROUGH CONDIUT
WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FE! (SUB TOTAL)
UTILITY CO NOTIFIED
PLAN CHECK FEE
FINAL
PERMIT ISSUING FEE 900
TOTAL FEE le1
PLAN CHECK VALIDATION CR M 0 CASH PERMIT VAL N cK MO CASH
.00-SI TIC 0 5 1 573 APR 11 2 A 6.00-
SEE
E!SAM OF APPLICATION FOR COMPLETE SCHEDULE