HomeMy Public PortalAbout5703 OAK AVE_Electrical_5/27/1968_r
76A663-CE8061-68 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISIONBING ADDRESS .�1"�7D,�i /v �Q�}/�
JOHN A. LAMBIE. COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITYNEAREST
FOR APPLICANT TO FILL IN CROSS ST.
NO. (EACH FEF
RECEPT I$ $ OWNER /9%4 G Q
'MAIL
LIGHT TOTAL FIRST 20 % 20 )ADDRESS
SWITCH /'Ar OVER 20
LIGHTING ITOTAL FIRST 20
FIXTURES r1 OVER 20
RA NGE_DRYER—WTR. HTR._
STA.COOK DISP. F.A.U.
SPACE HTR.-j—AIR COND.
CLOTHES WASH. DISHWASH.
FAN OTHER
MOTORS, TRANSFORMERS RATING
IND. HEATERS, ETC. HP. KW. KVA.
SIZE & TYPE OVER TO
0 - 1 1
1 - 10 1
10 - 50
50 - 100 1
100 - S00 1
SIGN, GAS 1
TUBE, OR SIGN AND ONE CIRCUIT 1
MARQUEE 1 ADDITIONAL CIRCUITS 1
SERVICE NOT OVER 600 VOLTS OR 200 AMP 1
SERVICE OVER 600 VOLTS OR 200 AMP 1
TEMP SERVICE, POLE, & APPURTENANCES 1
1.00
1.001
13.001
15.001
110.001
115.001
1 3.001
1.001
2.001
15.001
13.001
1
I
1 1 i
PERMIT FEE (SUB TOTAL) I
PLAN CHECK FEE (50% PERMIT FEE) I 1
PERMIT ISSUING FEE 12.001
SUPPLEMENTARY PERMIT ISSUING FEEL 1.001
TOTAL FEE
CITY ..J 41 TEL. NO.
PLAN CHECK
VO APPLICANT
ADDRESS
CITY TEL. NO.
CONTRACTOR
ADDRESS
CITY TEL. NO.
Q LICENSE IJO. CLASS.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
1 ELECTRICAL WIRING.
1 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
E
LICNSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY.
1
SIGNATURE
G�
OF PERMITTEE
1 FN
IST ` CCD N O. G R�,IJ P 7,Q �* PDQ S��Y
1 OTES: �- /���
PLAN CHECK VALIDATION CK. M.D. CASH
EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP. POWER POLE
UNDERSLAB WORK I j
ROUGH CONDUIT
WIRING
FIXTURES
POWER AUTHORIZED
O UTILITYCO.NOTIFIEDI
FINAL
JOSEPH C. ROOHAN
SUPERVISING ELECTRICAL ENGINEER
PERMIT VALIDATION CK. M. CASH
L&O.4
8,2 3-�S MAY 27 2 D 6.80