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fI76A663 DBS 5A 11 50 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES ELECTRIC I
WILLIAM J FOX CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO GROUP ZONE PERMIT NO
ELECTRICIAN /7q,3 o—,-�
RECEIVED BY READY FOR DATE ISSUED
ADDRESS 5134 N. Acacia St FIRST INSPECTION
CITY San Gabe TEL NO AT 68583
COUNTY LICENSE NO 1104 EXPIRES BUILDING
PERMIT FEES ADDRESS 5048 Alessandro Ave.
NUMBER EACH FEE LOCALITY Temple City
LIGHT OUTLETS 8 NEAREST
RECEPTACLES 14
CROSS ST
WALL SWITCHES 14 OWNER Turner Homes
TOTAL OUTLETS sc $ 1180 MAIL
ELEC RANGES 25 1 ADDRESS
ELEC HEATERS 2S CITY TEL NO
FIXTURES 8 5 40 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
MISC APPLICATION AND STATE THAT THE ABOVE IS CORRECT
NUMBER OF LIGHT CIRCUITS ' AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING
MOTORS 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS
NUMBER HORSEPOWER " ANGELES COUNTY LICENSE OR 1 AM THE LEGAL OWNER
NEW MVD HP OVER INC EACH
FEE OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE
1/2&LESS $ 251 25 SIGNATURE OF
1/2 2 s0 PERMITTE
2 s 1 00 INSPECTION RECORD
5 1s 1 so
is s0 2 50
50 200 5 00
200 Soo 10 00 J
Soo 1000 15 00 Q
Z
OVER 1000 20 00 (D
M G SET/FREQ CHANGER HP it
WELDERS AC KVA 0
GENERATORS KW
/ TRANSFORMERS KVA
..[ TEMP MOTORS (75%OF ORIG )
MOVED MOTORS (75%OFORIG )
MISC
SIGNS
NO NO TRANS I APPROVALS
NO NO LAMPS M
DATE INSPECTOR S NAME
FOR EACH PERMIT
WIRING $1 00 0 WIRING CONDUIT �&JrT���
FIXTURES $1 00 00
SUPPLEMENTARY 50 FIXTURES
4 45 POWER
TOTAL FEE $ UTILITYCO NOTIFIED
® FINAL I�
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