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" APPLICATION FOR PERMIT
DEPARTMENT OF BIIILDING AND SAFETY ELECTRIC
COUNTY OF LOS ANGELES
WILLIAM J FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT D GROUP ZONE PERMIT N,
ELECTRICIAN SS
RECEIVED BY READY FOR DATE ISSUED
ADDRES //�� / iFIRST INSPECTION
CITY TEL. NO V lI LL C44L
COUNTY LICENSE NO EXPIRES �� BUILDINGS[-7# �/'�( as
RE89f�// kk�3
ADD
PERMIT FEES FEE -6 chi,�,�/ ��
NUMBER OUTLETS EACH LOCA LITY1-1 ue }������y�/L+�,
Ao LIGHT Sc SNEAREST
CROSS ST.b)Y` Q4 Mk) A)d " "h?
RECEPTACLES 5 U
FIXTURES 5 OWNER
WALL SWITCHES 5 U MAIL
ADDRESS
ELEC RANGES 25
ELEC HEATERS 25 CITY TEL NJ 26% 1 4?
MISC 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
NUMBER OF CIRCUITS INSTALLED
TOTAL 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
NumEER HORSEPOWER FEE I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
rNEWHP OVER INC EACH ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
0 I2 a LESS--$ 25 OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE
%2 2 SO SIGNATURE OF
2 6 1 OO PERMITTEE --
s 15 , so INSPECTION RECORD
1s s0 z so
so zoo Soo
200 Soo 1000
500 1000 1500 �� Y A' �Q �� J
OVER 1000 2000 1 F 4 Ca
FREQ CHANGER HP /� 47 O_
WELDERS AC KVA GG Q'
O
GENERATORS - KW Q'
TRANSFORMERS - KVA
TEMP MOTORS (75% of ORIo) Az. /_ I
MOVED MOTORS (75% OF ORIO)
MISC
SIGNS
TYPE NO TRANS
TYPE NO LAMPS APPROVALS
FOR EACH PERMIT DATE INSPECTOR S NAME
WIRING $1 DO CONDUIT
FIXTURES $1 O0 WIRING
SUPPLEMENTARY 5o FIXTURES
A POWER
TOTAL FEE $ rf/ UTILITY CD NOTIFIED
FINAL L' v