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78A1383 CEB08 ,D 81 APPLICATION FOR ELECTRIC PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE COUNTY ENGINEER u'`
WILLIAM A JENSEN, SUP T OF BUILDING LOCALITY C�
NEAREST
FOR APPLICANT TO FILL IN CROSS Sr
1 T E M NO EACH FEE
OUTLETS (FIRST 20) $ $ �O OWNER
LIGHTS RECEPT 1 `� SW 20 MAIL
OUTLET ADD L UNITS ADDRESS
LIGHTS RECEPT SW ! 10 O
LIGHTING FIXTURES (FIRST 20) 20 O CITY TEL NO
LIGHTING FIXTURES (ADDITIONAL) 10 ELECTRI(ERWARDSON ELECTRIC CO. , Inc.
RANGES CLO DRYERS WTR HTRS 100 ADDRESS 8923 E1• Broadway
eDIS STA cooK O San Gabriel, Callf. AT. ?-Ub�5
CITY TEL NO
DISHWASH WASH STATE
SPACE HTRS STA APP ('/.H P S0 LICENSE NO
MOTORS OVER NOT OVER HP DISTRICT GR Z N PRO S D
otv
t 100
1 3 150 INSP TION RECORD e r
3 B 200 n.
O
8 15 250 ^„
15 50 300 O
50 100 Soo
d
SIGNS NO TRANS N
NO LAMPS Z
SERVICE O 600V NOT OVER 200A too
SERVICE O 600V OVER 200 A 200
SERVICE OVER 600V Soo
MISC
PERMIT ISSUING FEE 200
SUPPLEMENTARY PERMIT ISSUING FEE 1 00
TOTAL FEE $ I it
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR 9 SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING WIRING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR �
LICENSED AS REQUIRED Y LOS ANGELES COUNTY AND STATE OF FIXTURES /'
CALIFORNIA OR THAT M THE LEGAL NER TH ABOVE r
DESCRIBED RE NTIA ROPERTY POWER
SIGNATURE UTILITY CO NOTIFIED ./ Y
OF PERMITT FINAL YAL111
V LIDATION ARTHUR C VEIT
UCK MO CASH SUPERVISING ELECTRICAL ENGINEER
K MO CASH
LAL' 57841 GGT 19 2 D 14-30, v
78A663-CE°610,74 APPLICATION FOR ELECTRICAL ,PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER JOB O� CLO
BUILDING AND SAFETY DIVISION ADDRESS O
LOCALITY
NEAREST �..Mn 7 c(.S-�
FOR APPLICANT TO FILL IN CROSS ST L'1CJW�/1"�-� c- x
0 LETS NO EACH FEE O N NAME
RECEPT $ $ MAIL t+�
` FIRST 20 ADDRESS ��77
LIGHT TOTAL
CITY ��G TEL NO
SWITCH OVER 20 tp
PLAN CHECK t
LIGHTINGFIRST 20 "'o, APPLICANT `
TOTAL
OVER 20 ADDRESS
FIXTURES 10
RESIDENTIAL APPLIANCES CITY TEL NO ,
PERMIT
RANGE_/_DRYER_WTR HTR APPLICANT {}-
STA COOK-1 F A U ADDRESS I8 t9 ii^� 1`
SPACE HTR AIR COND CITY "-, TEL NO
CLOTHES WASH DISHWASH LICENSE OR O
REG NUMBER CLASS
FAN OTHER �1 IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS AIPPLICATION
ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND HEATERS ETC HP KW KVA ELECTRICAL WIRING
SIZE & TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 —_l 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF y.
CALIFORNIA OR THAI I AM THE LEGAL OWNER OF THE ABOVE C`L
' 1 — 10 300 OES GRIPED RESIDE NTI PROPERTY , C)
V
PERMITEE
10 - 50 500 SIGNATURE CD
U
50 - 100 1000 W
DISTRICT NO PROCESSED BY a-
d)
100 - 500 1500 Z
SIGN GAS SIGN AND ONE CIRCUIT 500 APPROVALS DATE INSPECTOR'S SIGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 100 TEMP POWER POLE '
SERVI CENOT OVER 600 VOLTS OR 200 AMP 300 UNDERSLAB WORK
SERVICEOVER 600 VOLTS OR 200AMP 1000 ROUGH CONDUIT --Z-
TEMPSERVICE,POLE, &APPURTENANCES 500 WIRING
TEMP LIGHT OR RECEPT SYSTEM 300 FIXTURES
POWER AUTHORIZED
( UTILITY CO NOTIFIED '
FINAL
PERMIT FEE (SUB TOTAL) NOTES
PLAN CHECK FEE Y
PERMIT ISSUING FEE
TOTAL FEE
v t
,PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M O CASH
8 255� IAN 26 �z 0 � ,
13.40 ,6�.b
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE a�