HomeMy Public PortalAbout9570 BROADWAY_Electrical__ DEDEA
OAPPLICATION FOR ELECTRIC PERMIT Z
76S633 53
DIVISION OF BUILDING AND SAFETY
Depaztinent of County Engineer l�
County of Los Angeles ao1NG 57� I
WM.J. FOX. COUNTY ENGINEER ADDRESS ]I
CASSATT D. GRIFFIN,SUPT OF BUILDING
LOCALITY ! b Nt,
FOR APPLICANT TO FILL IN NEAREST
PERMIT FEES CROss BT.
NUMBER EACH FEE
OWNER
` LIGHT OUTLETS
RECEPTACLES MAIL -
ADDRESS J Z`'� T�r^^� .1
WALL SWITCHES of
TOTALOUTLETS� 5Q $ CITYt l.4 ^ TEL. NO.
ELEC. RANGES 25 ELECTRICIA _
_ELEC. HEATERS 25 ADDRESS _ '7
KW EA CITY L. NCIO
FIXTURES 5 LICENSE NO.
NUMBER OF LIGHT CIRCUITS DISTRICT NO. GROUP I ONE READY FOR INSPECTION
r NUMBER OF RECEPTACLE CIRCUITS
MOTORS V F�
NUMBER HoasEPowFEE
ER INSPECTION RECORD
NEW MVO. HP OVER INC. EACH
Ifj A LE55 S .25
1 2 .50
_ 2 5 1.00
5 15 1,50 —
15 50 2.50
50 200 5.00
MISC.
NO.SIGNS NO.TRANS.
NO, SIGNS NO.LAMPS
FOR EACH PERMIT:
WIRING S1.00 0
FIXTURES
SUPPLEMENTARY .50 APPROVALS
_ TOTAL FEE Ig DATE INSPECTOR'S SIGNATURE
1 HEREBY ACKNOWLEDGE-THAT I HAVE READ THIS APPLICATION CONDUIT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING R �. D ���V
ELECTRICAL WIRING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR T I AM THE LEGAL AwNER OF THE ABOVEPOWER
DESCRIBED RESID T AL PROPE TY..
T 'UTILITY CO. NOTIFIED Gti
SIGNATURE Et
LL y
OF PERM FINAL
WILLIAM X, COUNTY ENGINEW VALIDATION A. C. VEIT,CHIEF ELECT. INSPECTOR
Ado 8 3 8 1 SEP 2 7 2 13'0 .