HomeMy Public PortalAbout5433 WELLAND AVE_Electrical__ 76AS63-CESOG 10/74 A ICATION FOR ELECTRIl- " L PERMIT
COUNTY 7S ANGELES
DEPARTMENT yr %-OUNTY ENGINEER ADDRESS U
BUILDING AND SAFETY DIVISION
LOCALITYNEAREST
FOR APPLICANT TO FILL IN CROSS ST. yV
OUTLETS NO. EACH FEE OWNER OR .S
FIRM NAME L ry
RECEPT._ $ $ MAIL
LIGHT TOTAL
FIRST 20 25 ADDRESS
Q�
�9TEL.
SWITCH_ OVER 20 10 CITY N0.
PLAN CHECK
LIGHTINGTOTAL F .f0IRST 20 .25 APPLICANT
FIXTURES
OVER 20 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL. NO.
PERMIT
RANGE ORYER_WTR. HTR. APPLICANT
STA. COOK DISP. F.A.U. ADbRESS
SPACE HTR, AIR COND.� CITY TEL. NO.
CLOTHES WASH. DISHWASH. w LICENSE OR /lyse ��",SS.
REG. NUMBER (nc'i
FAN OTHER IAO I 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 CE AT I AM PROPERLY REGISTERED AND/OR
0 — I jpp LICENSED 0 BY LOS ANGELES OUNT AND STATE OF
CdLIFOR AM THE LEG 0 N OF THE ABOVE O
1 — 1O 3.00 DESCR R IDENT11 OP RTY C1
PE cc
10 - 50 5.00 S1 I URE F
50 - 100 10.00 DISTRItT N0, PROC SED BY H
100 - S00 15.00
SIGN, GAS
.SIGNAND ONE CIRCUIT 5.00 APPROVALS DATE INSPEC R'S SIGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE
SERVI CE NOT OVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK
SERVI CEOVER 600 VOLTS OR 200AMP 10.00 ROUGH CONDUIT
TEMP SERVICE,POLE,&APPURTENANCES 5.00 WIRING /
TEMP LIGHT OR RECEPT, SYSTEM 3.00 FIXTURES
POWER AUTHORIZED T �•11�`�
UTILITY CO. NOTIFIED 1f v
FINAL 1�
PERMIT FEE (SUB TOTAL) NOTES:Ya,
PLAN CHECK FEESE�Vice am u''• �.- a,s_
PERMIT ISSUING FEE 3.00
TOTAL FEE
PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CK. M.0.
0 7 0 L%O,". 19 2 ®
10.5 a A98
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
n
lele C/
r6A668 CE-606(8/76) APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN JOB.. FNew Residential Bldgs.&Pools
EACH NO. FEE ADDRESS
1 &2-Family,Sq.Ft. $
.025 $ LOCALITY
Multi-family Sq.Ft. tl2
CROSS T. CZ &*W1,0IVJ2_F
Residential Swimming Pools 25.00 OWNER OR
FIRM NAME a
Outlets:Rec Ligha—Sw. .
MAIL
First 20 50 ADD RES .
Total No. Additional .30 CITY I t` �, Tel.N —
PLAN CHECK
APPLICANT
Lighting Fixtures First 20 •50 ADDRESS
Additional .30
Total No. Additional Tel.No.
Fixed Appliances Not Over 1 HP PERMIT C
Range_Heater_D.W._ APPLICAN . 6 1�
Oven'_Dryer_W.M. ADDRESS t
Top _FAU —W.H._ CI �eL Tel.No & 'l
Hood_Fan —Other LICENSE OR
Disp._Room Air Cond. 2.50 REG.NUMBER l h;L Closs:
THEREBY ACK OWLEDGE THAT I HAVE READ THIS APPLICA•
Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE-TO
Size&Type HP,KW,KVA,or KVAR COMPLY WITH ALL COUNTY ORDINANCES-AND STATE LAWS
2.50 REGULATING ELECTRICAL WIRING.
Up to 1 Incl. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
n-Ale Over 1 to 10 Incl. 5.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF 49
Over 1'0 to 50 Incl. 12.50 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
Over 50 to 100 Inc.
25.00 DESCRIBED' IDENTIAL PROPERTY
PERMIXEE
40.00
Over 100 JR
SIGNATURE
Services DISTRICT NO. P OCE D BY
0.200 Amp.Under 600 V 12.50 n
201-1000 Amp.Under 600 V 25.00 ?�
Over 1000 Amp.or Over 600 V 50..00 Z
O
Temp.Power Pole&Appurtenances 10.00
Sign.with.One Branch Circuit 10.00
Additional Sign Branch Circuits 2.00 INSPECTION > �3 1 4 2 3 A
INFORMATION u # 2
Misc.Conduits&Conductors 10.00 ON REVERSE z
Other(See Complete Fee Schedule) SIDE u 2 - 3200
Z
- 32005
PERMIT FEE (Sub-Total)
1.20-78
PLAN CHECKING FEE (One-Fourth Permit Fee) O
PERMIT ISSUING FEE $7.00 7 d D
TOTAL FEE 3 Z >
INSPECTION FINALED etc
• W
date: By e. es