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"MCATY®N OP, PEm8T
OFBqlDING AND SAFE-TY"
r COUNTY OF LOS ANGELES ELECTRIC
F I ENGLNEER
NAME DISTRICT-NO. GROUP I ZONE
>�PERMIT NO.
U ADDRESS
!r
UU CITY TEL.NO. RECEIVED READY FOR DATE ISSUED
FIRST INSPECTION -,;-11-
)L-�
ACOUNTY ,'1
CERT.NO. Q f.. EXPIgES
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
JOB
DESCRIPTION OF WORK ADDRESS2-6-/,:!Z .
NUM13ER OF OUTLETS ON CIRCUITS LOCALITY
LOCATION BY ROOMS NEAREST
LIGHT OUTLETS JSW. PLUGS FIXT CROSS 5
CIRCUIT A B C D E _ F G I H X NAME
MAIL
Is 60 /D 3 3 ADDRESS
O -
CITY TEL.NO.
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANG91 ES COUNTY CERT,f IQAj Q�UALIFICAT�IOIs
%® 4(- ELECTRICIAN.
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE
i OWNER.
COIO.IlYEGJO. ONS
1
6 - T9
A
Q
4 Z
I n
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I 1..1
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IL
/6 l6
ITH I I
NO. OF OUTLETS S' $ Z Z.Ar APPROVALS -
NO. OF FIXTURES DATE INSPECT'OR'S NAME
NO. OF MOTORS H.P. $ CONDUIT
NO. OF SIGNS TRANS. $ WIRING
NO. HEATERS $ 2 FIXTURES
MISCEI=kINE222POWER /� G
PERMIT FEE $ /.i7 UTILITY CO.NOTIFIED L - / - ✓ 4 N
=A!,FS FIN L
COUNTY of Los ANGELES APPLICATION FOR PERMIT
Department of Engineer
~- DIVISION OF BUILDING & SAFETY. '
WILLIAM J. FOX, County Engineer
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT NO.
ELECTRICIAN i S A '
RE ZE'v
D BY READY FOR DATE ISSUED
ADDRESS s ���7 .! I yj FIRST INSPECTION �
CITY TEL NO.,eh
COUNTY LICENSE NO. f�fO,S` EXPIRES `3e-7-�Srr ADDRESS
PERMIT FEES
FEE /J
NUMBER EACH LOCALITY �PF-P*
LIGHT OUTLETS NEAREST -
RECEPTACLES CRD99 BT. Z?�� f Jam►
WALL SWITCHES i OWNER /` tltOn e N/V/C[ H
TOTAL OUTLETS 5c $ MAIL (�
ELEC. RANGES 25 ADDRESS
ELEC. HEATERS 26
CITY TEL. NO.
FIXTURES b
MISC. , 0j e iff 1E'' p✓ I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING.
MOTORS `i 1 CERTIFY THAT 1 POSBESS THE ABOVE VALID LOS
NUM13ER HORSEPOWER FEE � ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL' OWNER
NEw MVD. HP DVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
V2 a LEea $ .25 SIGNATURE OF
%2 2 .50 PERMITTEE --
2 5 1.00 INSPECTION RECORD
5 15 1.50
15 50 2.50
50 200 5.00
200, Soo 10.00 J
SDD 1000 15.00 Q
OVER 1000 20.00
I7
_MOVED_MOTORS (75% or GRIG.) Q'
M.G. SET/FREQ. CHANGER-HP O
WELDERS-AC-KVA
GENERATORS - KW
TRANSFORMERS - KVA
MISC.
SIGNS
NO. NO.TRANS.
NO. NO. LAMPS APPROVALS
FOR EACH PERMIT. DATE INHPECTOR'B NAME
WIRING $1.00 CONDUIT
FIXTURES $1.00 WIRING
'SUPPLEMENTARY ,50 FIXTURES
POWER
TOTAL FEE ® / UTILITY CO.NOTIFIED
FINAL
76A663 DSS#SA Ob 12-53
COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
DEPARTMENT OF COUNTY ENGINEER
DIVISION OF BUILDING IS SAFETY
ELECTRIC 1'
WILLIAM 1. FOX, COUNTY ENGINEER
FOR APPLICANT TO FILL IN 7 D_IST CT NO., GROUP ZONE PERMIT O.
ELECTRICIAN �+
ADDRESS �' D T
R VED BY READY FOR E SUED
FI INSPECTION dry.
CITY TEL. NO ^ �q J
COUNTY LICENSE NO. EXPIRES BUILDING / i/j� ^+• `
P .r ADDRESS -L,
_
NUMBER EACH FEE LOCALITY
LIGHT OUTLETS NEAREST,- /
RECEPTACLES CROSS ST.-
WALL SWITCHES OWNER
TOTAL OUTLETS 5C $
MAIL
ELEC. RANGES 25 ADDRESS ,
ELEC: HEATERS 25
FIXTURES 5 S CITY _ 'TEL. NO.
MISC I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
NUMBER OF LIGHT CIRCUITS `
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRC61TIJ AND STATE LAWS REGULATING ELECTRICAL- WIRING.
MOTORS 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS
NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
NEW MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED A VE.
I/x&I.EsS $ 25 ` y
- SIGNATURE OF
I/z 2 50 PERMITTEE
_ 2 5 1.00 INSPECTION RECORD
5 15 1.50
15 50 2 50
50 200 5 00
200 500 10 00 J
500 1 1000 15.00 Q
OVER 1000 20.00
M.G. SET/FREQ. CHANGER-HP
.WELDERS: AC-KVA -
GENERATORS - KW .
TRANSFORMERS-KVA '
TEMP. MOTORS (75% OF ORIG.) _
MOVED MOTORS (75% OF ORIG.) -
• - f
MISC.
SIGNS "
N0 , NO. TRANS, APPROVALS
NO NO. LAM
PS FOR EACH PERMIT: DA INSPECTOR'S NAME
WIRING $1.00 CONDUIT
FIXTURES - $1.00 WIRING
SUPPLEMENTARY 50
FIXTURES /
POWER
TOTAL FEE UTILITY CO, NOTIFIED
oe. FINAL
76A 663 DBS#' BA. a-as