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76A663 DBS SA 11 49 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES T 1
WILLIAM J FOX, CHIEF ENGINEER
FOR APPLIT❑ FILL IN DISTRICT NO GROUP ZONE PERMIT NO
ELECTRICIAN p -c� ) � 41 ) o g2s
—v RECEIVED BY READY FOR DATE 168UEO
ADD FIRST INSPECTION-` „/+!
CITY EL NO ^ +"� /�` ,r ��y �+ r_g J U
COUNTY LICENSE EXPIRES Y ADDRESS / �►(�/$" / \
BLrlLDING
PERMIT FEES
FEE
�} NUMBER OUTLETS EACH LOCALITY
LIGHT gc ffi NEAREST
CROSS ST
-3 O RECEPTACLES 5
FIXTURES 5 OWNER
c 4I WALL SWITCHES s MAIL
25 ADD_RE6 /
`E[7E9.—FISA;F-SRS 25 CITY TEL
MISC I HEREBY A KNOWLE E THAT I HAVE READ THIS
NUMBER OF CIRCUITS INSTALLED
TOTAI APPLICATION AND STAH
T TAT THE ABOVE IS CORRECT
LIGHTS RECEPTACLES AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
MOTORS AND STATE LAWS REGULATING ELECTRICAL WIRING
NUMBER HORSEPOWERFEE I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
NEW MVD HP DVER INC EACH ANGELES COUNTY LICENSE OR I AM THE LEGAL OWNER
OF THE RESIDENTIAL PRO RTY SCRIBED ABOVE
V2 & LESS $ 25
%z 2 s0 SIGNATURE OF
2 5 1 00 PERMITTEr.
s is 1 so INSPECTION RECORD
is s0 2 5O
so 200 Sao
200 Soo 1000
r _ ✓/
Soo 1000 1 s DD
OVER 10011 2000 Alt
Z
M G SET/FRCq CHANGER HP CJ�/CC /V/I�J O
WELDERS AC KVA �- t`�
GENERATORS KW ��dV/!V(} IF
m,
C
TRANSFORMERS KVA f`A� /nlSTQL.L 'cy"'rs1
TEMP MOTORS (75% OF DRIG) d✓l�El, �` U AVIACING 9—n 17�=
MOVED MOTORS (75% OF DRIG)
MIsC
SIGNS
TYPE NO TRANS
T YPF NO LAMPS APPROVALS
FOR EACH PERMIT DATE INSPECTOR S NAME ry
WIRING $1 00 CONDUIT / !z)Ay
FIXTURES $1 00 WIRING
SUPPLEMENTARY 50
FIXTURES
POWER /
TOTAL FEE $ UTILITY CO NOTIFIED /.,/�� d
O FINAL
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