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1511113"^ II-•[ APPLICATION FOR PERPM
DEPARTMENT OFNG AND SAFETY ELECTRIC i
COUNTY OFF LOS LOS ANGELES
WILLIAM J. FOX, CHI[r ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO.
ELECTRICIANREADY MR 3o O
ADDRESS •Q.1_ -O R[ [IV BY rIRST IN/O)P�j[(�OTION /��jDAT[ ISSUED
CITY Lt T[L NO O , V v `7's—O
COUNTY LICENSE NO EXPIRES :�O:� BUILDING
PERMIT FEES EACH - - - _ ADDREee
—
NUMBER OUTLETS OH LOCALITY
LIGHT na NEAREST
CROSS BT
a RECEPTACLES B
/ rIXTUREe n OWNER
WALL SWITCHES n MAIL
LL RANGES 715 ADDRESS
[LEO HUTERB f6 Z+ Cin U TEL NO
M 1 HEREBY AOKHOWLLDGE THAT I HAVE READ T410
NUMBER Or CIRCUITS IN13TALLIED
TOTAL— APPLICATION AND STAT[ THAT THE ABOVE IB CORRECT
LIGHTS RECEPTACLES AND ACRE[ TO COMPLY WITH ALL COUNTY ORDINANCES
MOTORS AND STAT[ LAWS REGULATING ELECTRICAL WIRING
NuwB[R
NOR POWER ME I CERTIrY THAT 1 POSSESS THE ABOVE VALID LOB
N[w MVD "PI Ov[R I [^c:N ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER
• t[u B 215 Or THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
ZV2 B nD SIGNATURE Or � y/t�✓�
7 0 1 00 PERMITT[K t
n 115 1 Bo INSPECTION RECORD
1B Bo Seo
0o =q 000
9013 1500 1000
SDG 10013 11500 J
OVER 1000 90.00 =
MG SKT/rREQ, CHANGER-HP
WELDERS AO-KVA C
1 GENERATORS - KW O
TRANBFGRMER13 - KVA
TEMP. MOTORS (715 Or DRIB
MOVED MOTORS (715 of ORI")
BIONS
TYPES N6 TRANS.
TYPE Na LAMPS APPROVALS
TOR EACH PERMITS DAT[ INSPECTOR'S NAM[
WIRING 151,00 CONDUIT
►IXTUREB 81170 WIRINGSUPP"MCNTARY
1513 rIXTUREB
/ POWER
TOTAL FEE 6 ?D nun ca NGTIn[D I / /r'f>f/� A
�J rINAL