HomeMy Public PortalAbout5353 WELLAND AVE_Electrical__ IAG63-CEBOG 10-60 APPLICATION FOR ELECTRICAL PERMIT �
COUNTY OF LOS ANGELES
DEPARMENT OF COUNTY ENGINEERBUILD
ADDRESS C JJ sip 2^y Y 1 .
BUILDING AND SAFETY DIVISION-
'JOHN A. LAMBIE..COUNTY ENGINEER
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN ceoss sr.
PERMIT FEES OWNER
1 T S M NUM13ERI EACH FEE MAIL '
OUTLET $ $ ADDRESS
LIGHTS RECEPT SW. / .1O ® CITY TEL. NO.
LIGHTING FIXTURES ,10
ELEC.RANGES CLO.DRYERS ELECTRICIAN $
WATER HEATERS .50 ADDRESS 8993
--•i
ELEC.SPACE HTRS. DISHWASHERS c
CITYSan. Gabriel TEL NOAt— -0
GARBAGE DISPOSERS UT STATE
WASHER$►? STA.COOKING UNITS ,2g LICENSE NO.
17 A0 P7
MOTORSs OVER INC. H.P. D1SICT O. GR UP Z NE P ESSED BY
0— 1C. 2S
Va— 2 :50 INSPECTION RECORD
2— 5 1.00
5— is 1.50 U
is— so 2.50 ag
SO— 200 .5.00 O
G
SIGNS: NO TRANS. y
NO.LAMPS
. L
SERVICE 0-600V 1.00
SERVICE OVER 600V 5.00
MISC.
WIRING.PERMIT 1.00
FIXTURE PERMIT 1.00 O
SUPPLEMENTARY PERMIT ,so
TOTAL FEE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP (CATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT r / _ •7 4 �'
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED'AND/OR WIRING !�15`�l.'�// r_'�• i i'- ~.� -
LICENSED AS REQUIRED BY L08 ANGELES COUNTY AND STATE OR
FIXTURES I��fllr r`S1�'r�✓' �
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENT L PROPERTY. POWER 'r .I
SIGNATURE UTILITY CO.NOTIFIED Cid r. t
OF PERMITTE
' LIDATION ARri'HUR•C.VETT � °V
CK DCASH SUPERVISING ELECTRICAL ENGINEER
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