HomeMy Public PortalAbout5721 OAK AVE_Electrical_7/9/1973_]6.663-{t80610„2 APPLICATION FOR ELEC
ICAC PERMIT
COUNTY OF LOS ANGELES
BAEPARTMENT OF COUNTY ENGINEER JOB
BUILDING AND SAFETY DIVISION ADDRESS d/J
LOCALITY &_e, iL�CX/
NEAREST
FOR APPLICANT TO FILL IN _ _ CROSS ST.
OUTLETS NO. EACH FEE TOWNER OR
FIRM NAME,
RECEPT._�
$ S MAIL
FIRST 20 25 ADDRESS Lc�aL� !! �1 j [
LIGHT__ TOTAL OVER 20 10 CITY -77�� TEL. NQA+�p/CO�(yy✓__'_v! (T
SWITCH_ PLAN CHECK
LIGHTING FIRST 20 25 APPLICANT ,
TOTAI
OVER 20 ADDRESS
FIXTURES .IO
RESIDENTIAL APPLIANCES CITY TELL. NO. J
PERMIT �7/G �'\ /`•l��„V,�
RANGE_DRYERWTR. HTR._ APPLICANT:1�'
STA. COOK_DISP._F.A.U._ ADDRESS�q p { L
SPACE HTR. AIR COND. CITY l.ii TEL. NOl?X�4'MOS_
LICENSE ORC1A55.
CLOTHES WASH. DISHWASH._ I REG. NUMBER
FAN OTHEP 1.00I 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
ANO STATE THAT THE ABOVE IS CORRECT ANO AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND. HEATERS, ETC. HP. KW. KVA. I ELECTRICAL WIRING.
SIZE & TYPE OVER TO
HEREBY CERTIFY THAT AM PROPERLY REGISTERED ANO/OR
0 - 1 1.00 LICENSED AS REQUIRED I BY LOS ANGELES COUNTY AND STATE OF
n rALIFO THAT OR AM THE LEGAL OWNER OF THE A OVE
1 - 10 3.00 -"J ® DESLFI REO SIDE NTIpL P RERTT. O
l FERMITE V
10 - 50 5.00 SIGNATU F '�'�'
O
50 - 100 IOAO DISTRICT NO. , SED Y' IVy
100-500
�% s
SIGN, GAS (SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTOR`S SIGNATURE
TUBE, OR I
MARQUEE (ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE
SERVI CENOTOVER 600 VOLTS OR 200 AMP ` 3.00 d Q UNDERSLAS WORK
SERVICE OVER 600 VOLTS OR200AMP 10.00 ROUGH CONDUIT
TEMPSERVICE, POLE,&APPURTENANCES 5.00 WIRING ,
TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES
POWER AUTHORIZED
UTILITY CO. NOTIFIED
FINAL /
PERMIT FEE (SUB TOTAL) NOTES: Q'?1>
PLAN CHECK FEE_111-I GQ/� A\ -1,2� ,L
PERMIT ISSUING FEE 3.00 61 /_/// 0
TOTAL FEE
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALID ION CK. M.O. CASH
z 10 6.3 jUL 9, 9.0 0 -
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE