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76A663-CE806 11/70 APPLICATION FOR ELECTo✓P�ERM fl
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
COLEMAN W..JENKINS, SUPERINTENDENT OF BUILDING LOCALITY E pLG
NEAREST /,q
FOR APPLICANT TO FILL-IN CROSS ST. V OL J3 e j.7
OUTLETS NO EACH FEE
$ $ • OW .NER H{N S E E 2[
RECEPT MAIL
ADDRESS ,J I� �.7 rz
LIGHT TOTAL FIRST 20 25 `/`
SWITCH OVER 20 10 CITY E-MPj_,' J•'` TEL NO
PLAN HECK
LIGHTING
FIRST 20 25 APPLICANT
-TOTAL `
FIXTURES
OVER 20 10 ADDRESS
APPLIANCES CITY TEL NO
PERMIT
RANGE DRYERWTR HTR APPLICANT
STA COOK DISP F.A.0 I ADDRESS
SPACE HTR. AIR COND CITY TEL NO -
CLOTHES WASH DISHWASH. LICENSE NO. CLASS.
FAN OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE,ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING I 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
O - 1 100 + LICENSED A5 REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO >"
1 - 10 300 j RESIDE IN, .THE OVE- DESCRI ED SIDENTIAL PROPERTY O"
SIGNATURE U
10 - 50 500 i OF PERMITTEE
50 - 100 1000 O
DISTRICT NO JC AS NE rASS ED BY
ul
100 - 500 1500 - ' a
N
SIGN, GAS SIGN AND ONE CIRCUIT 500 NOTES: - Z
TUBE, OR
'MARQUEE ADDITIONAL•CIRCUITS 100 -
SERVICENOTOVER600VOLTS OR20DAMP 300 Lo 4D
APPROVALS DATE INSPECTOR'S SIGNATURE
S ERVI CE OVER 600 VOLTS OR 200 AM P 1000 .
TEMP.POWER POLE
TEM P SERVI CE,POLE, &APPU RTENANCES 5D
UNDERSLAB WORK
TEMP LIGHT OR RECEPT. SYSTEM' 300 ,
rl ROUGH CONDIUT
WIRING
FIXTURtS
POWER AUTHORIZED
PERMIT FEE (SUB TOTAL) ,
UTILITY CO. NOTIFIED
PLAN CHECK FEE -
. FINAL 7,e-, ,
PERMIT ISSUING FEE 300 •
H ROOHAN •
TOTAL FEE �� SUPESI G ELECTRICAL ENGINEER.
PLAN CHECK VALIDATION CK M 0 CASH PERMIT IV' AJOLSIFA;l
ION cK' M O' CASH
cq
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
7CAG93-Caeca 2-99 APPLICATION FOR ELECTRIC PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING
v am/ /4::
BUILDING AND SAFETY DIVISION ADDRESS F ,
JOHN A. LAMBIE, COUNTY ENGINEER
CASSATT D. GRIFFIN,SUPT OF BUILDING LOCALITY e - I
FOR APPLICANT TO FILL 1N NEAREST
PERMIT FEES CROSS ST. aj
ITEM NUMBER I EACH FEE OWNER 0 rO A AJ
OUTLET $ 10 $ ADDRESS ,MAIL S7
LIGHTS RECEPT SW. ) J �J
LIGHTING FIXTURES 10 CITY e /� TEL.NO. T Z7—A6 O
ELEC.RANGES CLO.DRYERS ELECTRICIANr
WATER HEATERS .SO ADDRESS
ELEC SPACE HTRS. DISHWASHERS
CITY TEL. NO.
GARBAGE DISPOSERS AUTO.- STATE
WASHERS STA COOKING UNITS .25 LICENSE NO
MOTORS, OVER INC H P. DISTRI T NO. GROUP ZONE ESSED BY
0— 1/2 .25 J
1/2— 2 .50 1 INSPECTION„RECORD ,
n
2— s 1.00
s— 1s Isois— so 250
50—200 500
SIGNS: NO TRANS
NO.LAMPS
SERVICE 0-600V 1.00 -�
SERVICE OVER 600V 500
MISC.
WIRING PERMIT 1.00
FIXTURE PERMIT too
SUPPLEMENTARY PERMIT s0
TOTAL FEE $
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS -DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE.TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT All
ELECTRICAL WIRING.
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR WIRING A. / ,p
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF p'IXTU RES , J/& ,
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL OPER POWER ` �� y
•SIGNATURE � I UTILITY CO.NOTIFIED-1y ��,�",'
OF PERMITTE •- FINA Y 1,J� %! lr�%��.�t.l'1'
®n ATION ARTHUR C.VEIT,' f'
SUPERVISING ELECTRICAL•ENGINEER
CK M0 CASH
648 4 8 8u, OCT 26 2 A 5.70 0