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+ APMCATION FOR PERMIT
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DEPARTMENT OF BUILDING AND SAFETY ELECTRIC 1
COUNTY OF LOS ANGELES
WILLIAM J. FOX. CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO.
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ELECTRICIAN -s-" -2-01
RECEIVED BY READY FOR DATE ISSUED
ADDRESS saw FIRST INSPECTION
CITY TEL. NO. V �[
COUNTY LICENSE NO. EXPIRES BUILDING 7r��7
%-, PERBUT FEES ADDRESS {V
SNUMBER OUTLETS EACH FEE LOCAL- (7
LIGHTS Sc
CRO86 ST.
REC PTACLEB B
FIXTURES 5 ,5 OWNER
L
WALL SWITCHES 3 MAIL ��11
ELEC. RANGES 25 ADDRESS i/ _ ; ,e
ELEC. HEATERS 25 CITYcZe_��E/.L/� ," TEL. NO
MISC.
NUMBER OF CIRCUITS INSTALLED: 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
LIGHTS RECEPTACLES AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
MOTORS AND STATE LAWS REGULATING ELECTRICAL WIRING.
NUMeEq HO
NEW MVD. HP OVER INC. EACH ORB POWER 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS
FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVG
.0 LE99 S .25 �-
V2 1.00 2 .50 SIGNATURE OF P .
PERMITTER"-
3
5 15 1.50INSPECTION RECORD
15 50 2.50
5o 200 5.00
200 boo 10.00
Boo 1000 15.00
a
OVER' 1000 20.00 _Z
M.Q. SET/FRED. CHANGER-HP 0
Ir
WELDERS: ACKVA 0
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (]b% or oRlc.)
MOVED MOTORS (]b% OF ogle.)
MISC.
SIGNS
TYPE: NO. TRANS. ern
TYPE: NO. LAMPS - APPROVALS
DATfi
FOR EACH PERMIT: INSPECTOR'S NAME
WIRING S2 00 CONDUIT
FIXTURES 01.00 WIRING
SUPPLEMENTARY .50 FIXTURES
POWER
TOTAL FEE g l r UTILITY CO. NOTIFIED
C7i FINAL G N