HomeMy Public PortalAbout9703 VAL ST_Electrical__ 76A6$3-CE$0E 11,70 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BonRess D 3 N
BUILDING AND SAFETY DIVISION
COLEMAN W JENKINS, SUPIERINTIENDENT OF BuILOING
LOCALITY
FOR APPLICANT TO FILL IN FOR
S
OUTLETS o EACH CROS ST
RE
yp 5 S OWNER
RECEPT JO MAIL
LIGHT TOTAL FIRST 20 ADDRESS
CITY TEL NO
SWITCH _70OVER 20 C) 10 S PLAN CHELK
LIGHTING FIRST 20 25 APPLICANT
TOTAL
OVER 20 ADDRESS
FIXTURES 10
APPLIANCES CITY TEL No
PERMIT O
RANGE
_ORYER_WTR HTR_ APPLICANT CO
STA COOK_DISP -k-- F A U JZ ADDRESS
SPACE HTR AIR GOND CITY TEL NO 7'a�ap
CLOTHES WASH A,"' DISHWAS� LICENSE NO as CLASS 42 d
FAN OTHER 100I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
ANO $TATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTOR
$ TRANSFORMER$ RATI NO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND HEATERS ETC NP KW XVA ELECTRICAL WIRING
312E a TYPE OVER TO
I HERESY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 - 1 100 LICE Na ED AB RED O I REO aY L03 ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO 1-
1 - 10 300 RESIDE IN THE ASOVE DESCRIBED RESIDENTIAL PROPER Y d
O
1SIGNATURE V
0 - 50 Bao
OF PERMITTEE
tr
50 - 100 1000 0
DlarRlcr Nop tt.a$ PRoc ss$D er
100 - Soo 15M , 00
SIGN GAS SIGN AND ONE CIRCUIT 300 NOTES H
TUBE OR I ?
MARQUEE 1ADDITIONAL CIRCUITS IN
SERVICENOTOVER 600 VOLTS OR 200 AMP 300
FFIXTURES
ROVALS DATE INSPECTOR'S SHKMTURE
SERVI CE OV ER 600 VOLTS 0 R 200 AM P 1000
WER POLE
TEMPSERVIC!,POLE &APPURTENANCES 500
B WORK
TEMP LIGHT,OR RECEPT SYSTEM 300
NDI UT
O
UT NO RIZEDPERMIT FEE (SUB TOTAL) CO NOTIFIEDPLAN CHECK F!EPERMIT ISSUING FEE 3 3 �� v —/-r 7SJOSEPH C ROOHAN
TOTAL FEE SUPERVISING ELE L ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M o CASH
276VAlL 7 2 24.75 •
SEE SAM OP APPLICATION FOR COMPLETE SCHEDULE