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7GA663 CE6061059 APPLICATION FOR ELECTRIC PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING --1
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PERMIT FEES CROSS ST
1 T E M NUMBER I EACH FEE OWNER
/
OUTLETMAIL
S $ $ ADDRESS f!
LIGHTS RECEPT SW IO
LIGHTING FIXTURES 10 CITY ze4,14a TEL NO
ELEC RANGES CLO DRYERS ELECTRI IAN
WATER HEATERS 50 ADDRESS (J
ELEC SPACE HTRS DISHWASHERS CITY TEL NO-9-,?-
GARBAGE
O
GARBAGE DISPOSERS AUTO
STATE
WASHERS STA COOKING UNITS 25 LICENSE NO 3 J 7
MOTORS OVER INC H P DISTRICT NO I GROUP I ZONE P CE SED BY
O— 1/2 ^ 25
1/2- 2 50 INSPECTION RECORD
2— 5 100 s= G
5— 15 150
15— 50 250
50-200 500
SIGNS NO TRANS (�, ���� �G'J• _ a
NO LAMPS
SERVICE O 600V too 1
SERVICE OVER 600V 500 t 'e`e 1J
MISC !!
WIRING PERMIT too
FIXTURE PERMIT 100
SUPPLEMENTARY PERMIT 50 4..-f
TOTAL FEE $
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT
ELECTRICAL WIRING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR WIRING
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL qjWNEFt OF THE ABOVE
DESCRIBED RESIDENT L PROPERTY POWER _
SIGNATURE UTILITYCO NOTIFIED V
OF PERMITTEE
r1NA
®1' /VWDATION tPRTHURC
MO CASH UERYISIN ELECTRICAL ENGINEER
4 �rJ 8 8 3 ,7 1-0 AM 5 2 A 200 "°
E I
SA 63 CE80 IO 81 APPLICATION FOR ELECTRICAL PER
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING J�
BUILDING AND SAFETY DIVISION ADDRESS A
JOHN A LAMBIE COUNTY ENGINEER Y
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY P L L` / 1
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
1 T E M NO EACH FEE
OUTLETS (FIRST 20) h $ 20 $ OWNER . L Q
LIGHTS I RECEPT SW MAIL
OUTLET (ADD L UNITS) 10 ADDRESS
LIGHTS RECEPT SW
LIGHTING FIXTURES (FIRST 20) 20 Q CITY TEL NO
LIGHTING FIXTURES (ADDITIONAL) 10 ELECTRICIAN `1/Q W /LnyIr Ezec r
RANGES CLO DRYERS WTR HTRS 100 ADDRESS d vJ �, • 7
GARB DISP STA COOK n / �/
CITY W'l L (//r TEL NO Al d �Q v
DISHWASH AUTO WASH STATE ? /1/� ri/ /y(_,�,�/O
SPACE HTRS STA APP ('/.H P MAX) 50 LICENSE NO .-0 Q
MOTORS OVER NOT OVER HP DISTRICT O GRO Z NE PWkCESSEDBy
O 1 ` 100 Q i 0 L
1 3 1 so INSPECTION RECORD
3 8 200 D'
O
8 15 250 U
15 50 300 0
s0 100 w 500 W
a
SIGNS NO TRANS H
NO LAMPS Z
SERVICE O 600V NOT OVER 200A 1100
SERVICE O 600V OVER 200 A 1200
SERVICE OVER 600V 500
MISC
PERMIT ISSUING FEE 200 Q
SUPPLEMENTARY PERMIT ISSUING FEE 100
TOTAL FEE 3
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DA/TE�1 INSPECTOR S SIGNATURE
D
ANSTATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING WIRING `1
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR L/r'
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES 7
CALIFORNIA OR THAT I AM TIJE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROP POWER
SIGNATURE UTILITY CO NOTIFIED
OF PERMITTEE
FINAL
�LIDATION ARTHUR C VETT '
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
�� 3 8 6% JuL31 2 D 3.6 ON cm
768663 CE806 ,D,72 APPLI ATION FOR ELECTRICAL PE MIT
`COUNTY OF LOS ANGELES
tiDEPARTMENT OF COUNTY ENGINEER
77F /
! BUILDING AND SAFETY DIVISION TY !T
FOR APPLICANT TO FILL IN CROSS ST
OUTLETS NO EACH FEE OWNER OR
$ $
7FIRM NAME
RECEPT! r MAIL •-
I�f FIRST 20 �,r ADDRESS /L�z'L ,a
LIGHT—�-* TOTAL 25
' 9
CITY �.y�/ / TEL NO
SWITCH OVER 20 10
PLA Ni
FIRST 20 CHECK
g
LIGHTING TOTAL 25 APPLICANT
FIXTURES
OVER 20 10 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL NO
//
RANGE DRYER WTR HTR PERMIT
APPLICANT \
STA COOK DISP F A U 'ADDRESS
SPACE HTR AIR COND CIITY TEL NO
CLOTHES WASH DISHWASH
REG LICENSE UMBER CLASS e /
FAN OTHER 100 "�
I HEk E61 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
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAI I AM THE LEGAL OWNER OF THE ABOVE
1 - lO 300 1 OESrRIf ED RESIDENTIAL PROPERTY
PERMITEE ^ U
10 - 50 500 SIGNATURE �j'<<^�✓'' ��
O
50`- 100 1000 DISTRICT PROC SE B IU
100 — 500 1j00 °—
SIGN GAS =SIGN ONE CIRCUIT 500 APPROVALS DATE SPECTOR S SIGNATURE
TUBE OR
MARQUEE ADDITIONAL CIRCUITS 100 TEMP POWER POLE
SERVICENOTOVER600VOLTS OR200AMP 300 UNDERSLAB WORK
SERVI CE OVER 600 VOLTS OR 200 AMP 1000 ROUGH CONDUIT
TEMPSERVICE POLE &APPURTENANCES 500 WIRING
TEMP LIGHT OR RECEPT SYSTEM 300 1 FIXTURES
4
POWER AUTHORIZED
UTILITY CO NOTIFIED
FINAL ? 1
PERMIT FEE (SUB TOTAL) �`� NOTES
PLAN CHECK FEEN
PERMIT SSUING FEE 1 { 300 �+ A
TOTAL FEE
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION cK M 0 CASH
5 1
69 AU I�� 2 0 1 10 0 Dos
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE