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8S,5A 3-55 'APPLICATION FOR ELECTRIC PERMIT
'BBe�SA
DIVISION OF. BUILDING AND SAFETY
•� Depazin ent o3 County Engineer R'
County-ot Los Angeles Bu1LDING p
WM.J. FOX. COUNTY ENGINEER ADDRESS I_LS� O CAp7P.na
' CASSATT D. GRIFFIN. SUPT OF BU LLD,HG rt --tt +
LOCALITY 3�0P11TJ1O �Zt.V
FOR APPLICANT TO FILL IN NEAREST
PERMIT FEES cR.S,ST. I,nular Aman Rd_
FEE
LIGHT OUTLETS
(NUMBER .EACH.
OWNER Thi lra xnc
-
RECEPTACLESMAIL
ADDRESS
WALL SWITCHES
TOTAL OUTLETS 2 5¢ $ CITY f��TTELNO.
ELEC. RANGES 25 ELECTRICIAN (nqini ap Y. son Fl apt,* c
_ELEC. HEATERS - 25 ADDRESS i mn N. (,rrtrtt9vi FT.i
KW EA CITYr)_ A (:n ri al TEL.NOl.ti n-Ann'
FIXTURES 5 LICENSE NO. l
NUMBER OF LIGHT CIRCUITS,
DISTRICT NO. GROr1IPl ZONE READY FOR,NSPECTION
NUMBER OF RECEPTACLE CIRCUITS
MOTORS
NUMBEaHORSEPOWER FEE INSPECTION RECORD
NEW MVO. HP OVER I ING EACH
Ih flLE55
h z so
2 - 5 1.00
5 5 1.50
IS 50 2.50
50 200 5.00
M ISC.
P tn1RR POT71 '
NO.SIGNS NO.TRANS.
NO.SIGNS NO:LAMPS
FOR EACH PERMIT: n
WIRING 51.00
FIXTURES S1.00
SUPPLEMENTARY .50 11 APPROVALS
TOTAL FEE S �!Y DATE INSPECTORS 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
ELECTRICAL WIRING. - -
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA. OR THA)P-?%AM THE-LEGAL OWNER OF THE ABOVE POWER A
DESCRIBED RESIDENT A RO E TY. UT -
ILITY CO:NOTIFIED
SIGNATURE
OF PERM ITTEE FINAL 1 A
WILLIAM J. FOX, COUNTY ENGINEER. VALIDATION A. C.VEIT, CHIEF ELECT. INSPECTOR
6 3 4 4 N MAY 2 4 2 1 .10 In
Y• s —YL/ ��
G9965A 11.59 APPLICATION FOR,.ELECTRIC PERMIT
DIVISION OF BUILDING AND SAFETY
Department of County Engineer auaDwG '
Counu of Los Angeles woDREss li fll fl f"�,m q�'1 n
JOHN A. LA
MBI E. COUNTY ENGINEER
CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY ipgm Tll q (;.j }gt
FOR APPLICANT TO FILL IN NEAREST IrOW P,T A9,t791
PERMIT FEES
NUMBER OWNER Mike ROv
LIGHT OUTLETS MAIL
_ RECEPTACLES - ADDRESS
7 WALL SWITCHES FEE CITY TEL. NO.
TOTAL OUTLETS @., 52 $ ELECTRICIAN Cone a & Son EZDOtTic
ELEC. RANGES 25
ADDRESS N rTTFI'Tl v' S
ELEC. HEATERS 25 -
KW EA - CITY SO Sn12 (TabriO TEL.
8 STATE
FIXTURES 5 0
LICENSE NO. 1�7 10
MOTORS
rvumeER FEE DISTRIX NO. , I GROUP I ZONE I READY FOR INSPECTION
_ HORSEPOWER .)
NEW. MVD. HP OVER INC. EACH
�@LE99 $ .z5 p INSPECTION RECORD
1/s 2 .50
2 5 1.00
5 15 1:50
i 15 50 2.50
50 1 200 5.00
misc. yJ (.l/ N t V 15:11
N .
n n]Rp "� l-�• F 1. d
i
NO. SIGNS NO.TRANS.
NO. SIGNS NO. LAMPS
FOR EACH PERMIT:
WIRING $1.00 1 (5-
FIXTURES $1.00 11 OO
SUPPLEMENTARY .50 APPROVALS
TOTAL FEE $ 4 7101DATE INSPECTOR'S SIGNATURE
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION ,/ -
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT I
�9
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING ' �G_yY/1 ..�•
ELECTRICAL WIRING. "
I HEREBY CERTIFY THAT i AM PROPERLY REGISTERED AND/OR �, FIXTURES 1
LICENSED AS REQUIRED BY OS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT ISA HE LEGA WNER OF THE ABOVE POWER
DESCRIBED RESIDENTIAL PR ER #L2
SIGNATURE I - UTILITY CO.NOTIFIED
OF PERMITTEE _ 1 FINAL
JOHN A.LAMSIE, COUNITY ENGINEER V ATION ARTHUR C.VEIT,CHIEF ELECT. INSPECTOR
CK MO . CASH
?Co7 1 0 ? ; •UUM 19 2 4.4 0
• � Roti.