HomeMy Public PortalAbout10787 BLACKLEY ST_Electrical__ / COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department of County Engineer
'0 DIVISION OF BUILDING & SAFETY
WILLIAM J. FOX, County Engineer
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO.
ELECTRICIAN G W Y1 �� 15- — � �'/ / ����
RECEIVE BY READY FOR 1 I DATE ISSUED
ADDRESS /����9� FIRST INSPECTION
CITY TEL NO.
COUNTY LICENSE NO. EXPIRES BUILDING
PERMIT FEES _ADDRESS 43 eeS�
y40 ,
NUMBER EACH LOCALITY KK�^
LIGHT OUTLETS NEAREST B '
CROSS 9T.
RECEPTACLES
WALL SWITCHES OWNER ti// �Y`rCt
` TOTAL OUTLETS Sc $ MAIL p� '
ELEC. RANGES 2g ADDRESS 1� ..•. f`_
ELEC. HEATERS 25 - CITY ( TEL NO.
FIXTURES 5
1 HEREBY CKNOWLEDGE THAT 1 HAVE READ THIS
MISC..
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
NUMBER OF LIGHT CIRCUITS I AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING.
MOTORS 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
NEw MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
%2 6 LESS '$ .25 _ SIGNATURE OF
I/2 2 .50 PERMITTEE • r
2 5 1.00 INSPECTION RECORD
5 15 1.50
15 50 2.50
50 200 5.00
200 500 10.00 J
500 1000 15.00 Q
Z
OVER 1000 20.00 E9
M.G. SET/FREQ. CHANGER-HP v
WELDERS:AC-KVA , 0
GENERATORS - KW
TRANSFORMERS - KVA _
TEMP. MOTORS (75% OF ORIG.)
MOVED MOTORS (75% Or ORIG.)
MISC.
SIGNS
NO. NO.TRANS.
APPROVALS
NO. NG. LAMPS
DATE _ INSPECTOR'S NAME
FOR EACH PERMIT:
WIRING $1.00 CONDUIT
FIXTURES $1.00 WIRING
SUPPLEMENTARY .50 FIXTURES rID'I7-dl � �lit�
POWER
TOTAL FEE 5 D UTILITY CO.NOTIFIED
FINAL
76A663 D65#5A 2-53 ,
D13S 6-A 6-46 APPLICATION
�FOR. PEW=
DEPARTMENT OF F LOS AG ANDELE sA&'ETY E��� A�I�;
COUNTY OF LOS ANGELES ,
WM. J.6FOX CHIEF ENGINEER
Z Uy j f� �/ fie' y ��// DISTRPT NO. GROUP ZO E. PERMIT O. -
Q NAME_�f�r'A�Nm���]o �J�a�°fdrfs�a,�ldJ / X// /
ADDRESSk-- READY FOR Y�
1� VA � �tom'4d "' �► / �3-�
WU CIT /� / Ey TEL.NO� �1�F BY FIRST INSPECTION DATE ISSUED.
W £CERT.NO. EXPIRES
'APPLICANT FILL IN-HEAVILY OUTLINED PORTION ONLY
JOB
(DESCRIPTION OF WORK ADDRESS
NUMBER OF OUTLETS ON CIRCUITS LOCALITY
LOCATION BY ROOMS -
NEAREST
LIGHT OUTLETS SW. PLUGS FIX.T CROSS ST.
CIRCUIT IA B C :D E F G H /!y a NAME I-9 q�WZ MAIL
/ / 3 ADDRESS `q�
O TEL.NO�Cl a ��a *��� AC'/3d I� I
_ 1 AM THE LEGAL�POSSESSOR-OF 'TH ft ABOVE LOS
GELES COUNTY CERT( ICATE>OF QUALIFICAT O
N c ANN.,
p�{� •y /'�ELECTRICIAN.
I AM THE"GAL OWNER OF THF. PROPERTY DESCRIBED
�f fr1 1 y��� �� ABOVE
!f �• ';i_&✓/°"(eft„� OWNER.
CORRECTIONS
J
Q
z
2
[Y
O
TOTAL
NO. OF OUTLETS ; ' $ . APPROVALS
NO. OF FIXTURES $ DA INSPECTOR'S NAME
'01
NO. OF MOTORS H.P. $ CONDUIT ;
r
NO. OF SIGNS TRANS. $ ,sem ,WIRING
NO. OF RANGES OR HEATERS / $ 3 FIXTURES
MISCELLANEOUS /
$ POWER
PERMIT FEE $ I �yUTILITYCO.NOTIFIED
TOTAL FEE +�� '7 FINAL