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�IaAO&-CESOB 6-52 APPLICATION F R ELECTRICAL kRMIT
COUNTY OR LAS ANGELES
DE PARTMENT OF COUNTY ENGINEER DUILDIN
BUILDING AND SAFETY DIVIBION ADDR>�
JOHN A. AMdIE, CouxTY ENGINEILR
WILLIAM A.JENSEN, SUPT OF BUILDING LOCALITY
NEAREST
OR APP Fill CROW ICT.
RECEr T. TOTAL NO, KAqH
' -OUTLM FIRST 20 IQ E OWNS
LIGHT MAIL
AWL 10 ADD
SWITCH. OYER 20
LIOHTINO TOTAL FIRST 20 .10 QTY TEL N0.
FIXTURES oA^I0 ,10 F-LECTR1 AN
I7AN CLO.CKYIDS WMTRS. 1.00 ADDRESS
TR .
aAJEL Dian. . aTA.COOK CITY ^ , N0.
1XSIfWASH. AUTO,-WASH. STATE
iPAM ITTIO. STA.A".(%H.F.MAX.) ,50 [LICINGE NO.
MOTORS. oval NOT woe HS. DIST CT O. GRO NQ 1p QD dY
0 1 1.00 64
t s 1.50INSPECTION RECORD
s e 2.0.0 �A
5 15 IL 50
Its Ito 3.00 8
ix
50 160 5.00 0
O
NO.TEAM& �
SIGNS, NO.LAMPS JA
`
r
BaRvlbab-500V•No'Twoe:OOw 1.00
SERVICE O-GOOV-OYoe 100 A. LOO
SERVICE OYER 5o0y 5.00
MISC. tr
i
PERMIT ISSUING FII 1.00
SUKLKMKNTAQY FERMIT I101N0 FEE 1.00
TOTAL FQQ •
1 HAY AO3LOY/4KDaZ THAT I HAY[ READ THIS TION TZ
AND STATIC THAT TSR ASOYK 1■ COMIKCT AND AGINIM TO COMPLY CONDUIT
WITN ALL -COUNTY ObINANCX5'AKD STATIC LAWS RKGULATING
KucTIMCAL 1'IDe1NG. WIRING
I HEREBY CXFM Y THAT 1 AM PROPERLY ROISTVIKD AND/OR IF
��3.I��� RK
Alm OUII®SY LOG; ANGSLKS COUNTY AND STATK OF FDrrumm
JV`ALVORNIA ON THAT 1 AM THK OWMM OF TJ-IX ASOYK
DtaCJe� less Pvx)pg3 r. * pOWE1k
RE UTILITY N FI
or TU
FINAL O
LIDATION A RYHUR C.
CK MO 'CASH Surowtoma EI..ECTRICAL ENGINNAR
LAC05216Q� DOT 5 2D 4.00- 4
" ��e t e e a - i e e o e , 1 � A P P L I C A T I O N F O R E L E C T R I C A L P E R M I T
C O U N - E Y O F L O S A N G E L E S f l I
` D E P A R T M E N T ' O F C O U N T Y E N G I N E E R B U I L D I N G [ �� + �� /
B U I L [ ? 1 N G A N D S A F E 7 T I f D I V I S I O N A D D R E S S J - e
, J O H N A . L A M B I E . C S u N T Y E N G I I N I E E R
C O L E M A N W . J E N K I N S , S U F L R 1 N Z 1 1 E N 1 D E N T o f B U I L D I N G L O C A L I T Y
N E A R E S T
F O R A P P L I C A N T T O F I L L I N C R O S S S T ,
N O , E A C
F E O W N E R
M A I L T O T A L F I R S T 2 0 - Z D . 2 0 Q d A D D R E S S O ��L ��L O V E R 2 0 O . 1 0 D C I T Y q t , ��. L N O .
P L A N C H E C K
L I G H T I N G T O T A L F I R S T 2 0 . 2 0 1 6 D A P P L I C A N T . * V L , O x
F I X T U R E S O V E R 2 0 . 1 0 - 1 , 1 1 0 A D D R E S S
R A N G E / . D R Y E R - t - W T R . H T R . C I T Y T E L . N O .
S T A . C O O K _ D I S P . F . A . U . C O N T R A C T O R ' F
S P A C E H T R I A I R C O N D . A D D R E S S 0 j q & 4 o Q A a
C L O T T ��H E E S / S W A S H . I D I S H W A S H C I T Y 5 1 1 / i i - - �� T E L . N O .
F A N O T H E R 1 . 0 0 L I C E N S E N O C L A S S .
M O T O R S , T R A N S F O R M E R S R A T I N G
I N D . H E A T E R S , E T C . P .
K W . K V A . I H E R E B Y A C K N O W L E D G E T H A T I H A V E R E A D T H I S A P P L I C A T I O N
S I Z E T Y P E O V E R T O A H D S T A T E T H A T T H E A B O V E I S C O R R E C T A N D A G R E E T O C O M P L Y
W I T H A L L C O U N T Y O R D I N A N C l i g A N D S T A T E L A W S R E G U L A T I N G
E L I C T R I C A L W I R I N G .
0 - 1 1 . 0 0
I H E R E B Y C E R T I F Y T H A T I A M P R O P Q R L Y R E G I S T E R E D A N D / D R
1 - 1 0 3 . 0 0 L I C E H I E D A S R E Q U I R E D B Y L O S A N G E L E S C O U N T Y A N D S T A T E O F
C A L I F O R N I A O R T H A T I A M T H E L E G A L O W N E R O F , A N D I N T E N D T O
1 0 - 1 5 0 5 . 0 0 R E S I D E I N , T H E A B O V E D [ S C R 1 r 7 E D R E S I D E N T I A L F R O F E R T Y . O
S I G N A T U R E - V
5 0 - 1 0 0 1 0 . 0 0 O F P E R M I T F - O !
t o o S o o t a . o Q
D I S T I T N G R O Z E P C E E D B Y
S I G N , O A S
S I G N A N D O N E C I R C U I T 3 . 0 0 L ����T T L i i
T U B E , O R _ C L
M A R Q U E E A D D I T I O N A L C I R C U I T S 1 1 . 0 0
N O T E S :
S E R V I C E N O T O V E R 8 0 0 V O L T S O R 2 0 0 A M P L . 0 0
S E R V I C E O V E R 6 0 0 V O L T S O R 2 0 0 A M P 5 . 0 0 i
T E M P S E R V I C E , P O L E , h A P P U R T E N A N C E S 3 . 0 0 A P P R O V A L S D A T C I N S P E C T O R ' S S I G N A T U R E
T E M P . P O W E R P O L E
U N D E R S L A B W O R K
R O U G H C O N D U I T
P E R M I T F E E ( S U B T O T A L ) W I R I N G
- F I X T U R E S
P L A N C H E C K F E E ( 5 0 % P E R M I T F E E )
P O W V A U T H P R I Z E D
P E R M I T I S S U I N G F E E 2 . 0 0 U T I L F I E D
S U P P L E M E N T A R Y P E R M I T I S S U I N G F E E 1 . 0 0 F I N A L
T O T A L F E E O I O S O P H C 4 0 0 H A N
S U P E R V I S I N G E L E C T R I C A L E N G I N E E R
P L A N C H E C K V A L I D A T I O N C K . M . O . C A S H P E R M I T V A L I D A T I O t j : : ���� M . O . C A S H
L A C 0 4 4 3 V E A P a 2 5 2 D 2 2 . 0 0 ' q
S E E B A C K O F A P P L I C A T I O N F O R C O M P L E T E F E E S C N E D U L F
75Aee3t[e0e 1-e7 APPLICATI R ELECIMCAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION A IDRMS
JOHN A. LAMBIE. CouNTY ENa1NE[R
COLEMAN W. JENKINS, SUMRINTENDtNT OR BUILDING LocAt.tTr
NF-ARFAT
FOR APPLKAM TO FILL IN CROSS ST.
RECFPT. 1 TOTAL NO. LAcH
FXK
O tT o FIRST 20 .2O � OWNER AJ'
LIGHT 2 J} MAIL nn
ADD'L ADD IltM O-24IV 4A A M
(WITCH 2 OVER Y .10
1
LIOHTIN� TOTAL FIRDT 20 .10 d CITY E L TZL-N0. - S
l FIXTURRf _
FIXTUR[D 1 ADD'L
OV¢R 20 .10 CONTRACTOR O
RAMa= DRYus WTR.HTFW 1.00 ADDRA"
DAIS.DI up. -JI'TA.ODOR
CITY TttL N0.
DISHWA1F1. AUT0.•WASH. STATIL
QAZZ HTWAL BTA. AITL .Bp LICENSK NM
MOTORS Ovu NOTOVnI H.P. DISTRICT d UP ZONE P C D EY
1 1.00
1 , 1,150 INSPECTION RECORD
s e 1,00
B
15 1.60
to BO 3.00
Bo t q0 5.00 O
SlaAlsi MO.TRAMX
M0.LAMPS
SICRVICK O.500V•NOT ov0.20OA 1.00
SKRVICL 0-00ov-Ovoe 2A0 A. 1.00
=MVICK OVER BOOV B.QO —
OTHER (at[ C"rL[T[F[[SCHICuL[)
r[RMIT ISSUING Fix LA0
SUrlrL mmNTA1RY PRAMIT ISbUtNG Fti 1.00 ArrRWALS GA
TOTAL FEE I s —,!
UND[RBLAB WORK
1 KVA Y ACKNOWULDG[ H
THAT I AV[Rn
ZAD THIS ALICATIOJw4RINQ AND BG
TAT[THAT TH[AOV[IB COARiCT AND AMMM TO COMMROUGH CONDUIT
WITH ALL CDUNTY ORDIKAX ANC BTAT[ LAWS ISGULATIN
[IICTRICAL WIRING.
I -I -FT THAT 1 AH PwOrOILY R[GISTSPMD AND/Oft FUCTU
VCi NStD AS R[OUIRID ■Y LOS ANG[Lts COUNTY AND BTAT[OF
CALIFORNIA p►I THAT I AM TH[L1GA-OWN[R OF D INTLND PoWtLpt
R[SIC[IN,TH[ VR YCIISCAIMILD RZSI IA
SIGNATUR[ UTILITY
OF FXRM f
FINAL
�I JOSEPH G ROOHAH
CK MOO CAS WH BUr1t]IVtSINd RX.[CTRICAL ENdlNmt
LAGO.9 7 6 4% JL25 2 D 5.00^
APPLICATION FOR ELECTRIC PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OFUNTY ENGINEER BUILDINa
BUILDING AND SAFETY DIVISION ADDRESS O
JOHN A.LAMBIIL COUNTY ENGim=M
QAAMsATr D.uRiF71DL Sur.c w aun..oam LOCALITY10,141
FOR APPLICANT TO FILL IN NEAREST
PEMMT F=
ITEM NUYSJD[ EJ.CH Pii OWNR
MAIL
OUTLETS: s s ADDRESS
u0H-n RtC=rT. M. .10
LIGHTING FIXTURE8 .10 10 kE-'�L!.ECTMC"
'�
n rr MANGEs CLO.DRYtlts
WATER HEATERS .50 DREBHnilR[C./PACE HTRS. DI<HWAliHR7rr TE No.
GARSAOE DISTOS[RS AUTO.- TATE
WASHERS 9TA.COOKING UNITS .25
MOTORS: OVL12 INC. H.P. -
0— 1A .25 .� ..rNE IC
YR— s .50 IN3P=ON B.ECOBD
2— is 1.00
5— 15 1.50
15— 50 2.50
50-200 5.00
HIGNB: NO.TRANS.
NO.LAMPS
OFRwCa aeooV 1.00
SHRIKE OVER 600V If
D.oO
Y1pC. � 7i
WIRING PERMIT 1.00
FIXTURE PERMIT 1.00
SUPPI..EMENTARY PERMIT .50
TOTAL F s APPfiOVAIS
IH
ACKNOWLEDGE THAT 1 HAV[ REALIC
D THIN APPATION DAT[ 111STECTOR'■SIGN TURF
AND SAT[ TMT THE A5OV[ Ie CORRECT AND AGREE TO COMPLY
WfTN ALL COUNTY ORDINANCYS AND QfATE LAW{ REGULATING CONDUIT
ELECTRICAL WIRING. WIRING H �/
I HERE" 4R"MFY THAT PRO Y REGIST)tRED AND/OR
LI CKND ED Al REQUIRED
E AN COUNTY AND STATE OF FIXTU REB
CALIFORNIA OR THAT [ Li THE AIWV[
DESCRIEED REDIDWTI POWER
SIGNATURE UTILITY CO.NOTIFI®
OF PERM I
!G
(b' VAI.IDA gR HU C. VSIT.
CK
NO uPtrtv►slNa CT RI tYR
�,p 6 9'9 8 PAY 5 2 A 2.70