HomeMy Public PortalAbout5322 WELLAND AVE_Electrical__ :7F�663-'CE806 11-71 ' APPLICATIO FOR ELE IUCAt' PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER FNEAResT
S a � &�LL i
BUILDING AND SAFETY DIVISION
Y �/J
FOR APPLICANT TO FILL IN T. /�ee-f
OUTLETS N0. EACH FEE
7$` OWNER � � C�
RECEPTm� $ $ MAIL /Gr/,
������ ADDRESS 0 S:2 /� ��IIJJ
LIGHTS 0 TOTAL FI RST 20 25 � ��
SWITCH!SS !E OVER 20 CITY G PC/�ti>G' TEL. N0., . .2t
10 �� PLAN CHECK
LIGHTING 1 TOTAL FIRST 20 25 J1�j� APPLICANT
FIXTURES
1( OVER 20 10 1�,�, ADDRESS
RESIDENTIAL APiPLIANCES CITY TEL. NO.
PERMIT
RANGE-DRYER_WTR. HTR. APPLICANT !.
STA. COOK DISP. L� F.A.U. ADDRESS, �® �K�
SPACE HTR. AIR COND. CITY Q(f�� TEL. N0. 9 3 JJ15I
i
CC WASH. P"DISHWASH. �, LICENSE NO. �r,117 CLASS. Cld
FAN f�"OTHER � 1.00 �y�J
!J v 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING.
SIZE & TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 — I 1.00 LICENSED AS REQUIRED BY I�NGELES COUNTY AND STATE OF
//yy CALIFORNIA OR THAT I A THE LEGAL OW R OF, AND IN
TO
•�� 1 — 10 3.00 K...G RESIDE IN, THE AB E DES •IBED SIDE NTIAL PROPERTY. V
ai" SIGNATURE y�
10 - 50 5.00 OF PERMITTEE
0
50 - 100 10.00
DISTRICTNO. CLASS ZONE P ESSED BY W
100 — Soo 15.00
Z
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOTES,
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00
SERVICENOTOVER600 VOLTS OR 200AMP / 3.00 QlD
APPROVALS DATE INSPECTOR'S SIGNATURE
SERVICEOVER600VOLTS OR200AMP10.00
TEMP.POWER POLE
TEM P S ERVI CE,POLE,&APPU RTENAN CES 5.00
UNDERSLAB WORK
TEMP LIGHT OR RECEPT. SYSTEM 3.00
ROUGH CONDIUT
WIRING }
FIXTURES
POWER AUTHORIZED
PERMIT FEE (SUB TOTAL)
UTILITY CO. NOTIFIED
PLAN CHECK FEE ) ryry��yy e�y
PERMIT ISSUING FEE 3.00 FINAL
TOTAL FEE
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION/ C M.O. CASH
v
I ir- 1, 8 7 873 JUN 26 2D 3 9.5 0, v
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE