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76A6fiC-CE#806 5-61 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES ,:y...
DEPARMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION AooREss Y� n
JOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A.JENSEN, SUPT OF BUILDING LOCALITY i L -
.NEAREST
- FOR APPLICANT TO FILL IN cRo55 sr. 7
PERMIT FEES OWNER '
I T E M NUMBERI EACH FEE MAIL i /
ADDRESS
OUTLETS: - $ $
/ � 1
LIGHTS RECEPT. 6W. .IO CITY �i —TE
LIGHTING FIXTURES,
IO
ELEC.,RANGES CLO. DRYERS ELECTRI/IAN" // j
WATER HEATER 6 .SO ADDRESS
ELEC.SPACE HTRS. DISHWASHERS / "I
CITY
GARBAGE DISPOSERSAUTO.- STATE
WA6HER6
ETA.COOKING UNITS ,2$ LICENSE NO. IL
.MOTORS: OVER INC. H.P. DISTWCT NO. IIGRrl Z - E P "ESSED BY
0— Yn .25 `j' a Gl
I/,— 2 .50 I !$PECTION RECORD
i N
2— 5 1.00 �L O
5— 15 1.50 ,�,�� U
IS— 50 2.50 O" Ix
O
so— 200 ~
8.00 V
W
NO TRANS.
SIGNS: N
NO,LAMPS Z
SERVICE 0-600 V 1.00
SERVICE OVER 600V 5.00
MISC.
WIRING PERMIT 1.00 _
FIXTURE PERMIT
SUPPLEMENTARY PERMIT 50 (J
TOTAL FEE $ C,
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'SSIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
1HEREBY CERTIFY THAT'1 AM PROPERLY REGISTERED ANO/OR
LICENSED AS REQUIRE BY LOS .GELS COUNTY AND 6TATE OF " FIXTURES .
CALIFORNIA OR THAT/ AM THE LEG O NER THE ABOVE
DESCRIBED RESIDENTIA P RTK POWER
SIGNATURE : UTILITY CO.NOTIFIED
OF PERMITTEE FINAL
IDATION ARTHUR C. VEIT '
/cn MO CASH SUPERVISING ELECTRICAL ENGINEER
Ijlo219 - B ] � 2 .p .75
fiA66G-DEj-"8O6.5-B1 APPLICATION FOR ELECTRICAL PERMIT ' u
COUNTY OF LOS,ANGELES -
DEPARMENT OF COUNTY ENGINEER Qau LDlrvc
BUILDING AND SAFETY DIVISION ADDRESS
JOHN,A. LAMBIE. COUNTY ENGINEER, -
WILLIAM A. JENSEN, SUP T OF BUILDING '� LOCALITY Q
a _ NEAREST
FOR APPLICANT TO FILL IN CROSS ST. -
PERMIT FEES .OWNER'
^ IT E.M, NUMBERI EACH I FEE MAIL
ADORES
OGTUHA $- $
I
CITY TEL. NO.
- .10
LIGHTI GFIXTURE 10 -
ELEC. RANGES CLO; DRYER +' ELECTRICIAN
WATER HEATERS .50 ADDRESS
ELEC.SPAFE-JiTRS. OI$HWASHER9'
CITY - EL
GARBAGEJ(/ (/D15P05ER5 AUTO, / STATE
WASHERS STA.COOKING UMTS 25 v LICENSE NO. '
r
MOTORS: OVER INC. H.P. DIST ICT O. G UP Z IPR SSEDBY
0— 4a 25
v:- z SG INSPECTION RECORD
2— 5 Loo 0.
5— 15 - 1.50 U
15— 50 2.50 'C
50— 200 8.00 V
W
'SIGNS: NO TRANS.
NO..LAMPS _Z.
SERVICE 0-600V 1.00.'
SERVICE OVER 600V 5:00
MISC.
WIRING PERMIT 1.00 FIXTURE PERMIT 1.00
P
SUPPLEMENTARY PERMIT 150
TOTAL FEE
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
ANO-STATE'THAT THE ABOVE-I5 CORREC -AND AGREE TO COMPLY ECONDUIT^'
WITH ALL, COUNTY ORDINANCES AND STATE LAWS REGULATING
ELCTRICAL WIFING. WIRING
I HEREBY CERTIFY THAT I AM •PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REOUIREO L05 ANGEL COUNTY A O STATE OF
CALIFORNIA OR THAT 1 M'THE LEG OW ER THE ABOVE•. -
DESCRIBED RESIDENTIAL R Y. POWER - .n( ♦�11( /I q a,..�..�.��GJ,{�} '
SIGNATURE UTILITY_CO.�NOTIF.IED .
OF PERMITTEE �- FINAL
-� -/VY{ 1DATION ARTHUR C. VEIT
MO CASH - SUPERVISING ELECTRICAL ENGINEER
1
LEi o5 4'1 1 ` tmv 24 . . 2 D 11 .00 .
T6A660'-CE$06`- -68
APPLICATION FOR ELECTRICAL PERMIGT lJ=
COUNTY OF LOS ANGELES -
DEPARTMENT OF COUNTY ENGINEER BUILDING r -
BUILDING AND SAFETY DIVISION AUILDIN Q e,
JOHN A. LAMBIE. COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY /
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
NO. AC FEE
:r-
R ,— S S OWNER
MAIL
LIGHT_ TOTAL FIRST 20 .20 ADDRESS
SWITCH__ OVER 20 .10 CITY TEL. NO.
PLAN CHECK
LIGHTING lTOTAL FIRST 20 .20 APPLICANT
FIXTURES I OVER 20 .10 ADDRESS
RA NG E_D R ER—W T R.HTR.— CITY TEL. NO.
STA.COOK_DIS P._F.A.U._ CONTRACTOR
SPACE HTR. AIR COND- ADDRESS /
CLOTHES WASH._DISHWASH.—L
CITYflTAIE TEL NO.
FAN—OTHER 1.00 // � //
LICENSE 14 0. p'ya.(T CLASS
MOTORS.TRANSFORMERS RATING
IND. HEATERS. ETC. HP. KW. KVA. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE & TYPE OVER TO A NOWIT STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
O — 1.00 ELECTRICAL WIRING.
EEBY CERTIFY THAT AM PROPERLY REGISTERED AND/OR
I 10 3.00 LICENSED AS REQUIRED BY LOS ANGELESLES COUNTY AND STATE OF
CALIFORNIA OR THAT
AM THE LEGAL OWNER OF, AND INTEND i0
10 - 50 $,00 RESIDE IN. THE MOVE OESCPIP.EO RESIDENTIAL PROPERTY.
50 - 100 1 0.00 SIGNATURE /i Cl.
OF PERMITTEE /� 19t vlld��
U
loo – Soo 15.00 DIST�1 T GROUP Z E PROCESSEQ BY p
SIGN,GAS SIGN AND ONE CIRCUIT T 3.00
TUBE. OR w
MA ROU EE gOOI TI DNAL CIRCUITS 1.00 NOTES: h
Z
SERVILE NOT OVER 600 VOLTS OR 200 AMP 2.00
SERVICE OVER 600 VOLTS OR 200 AMP 5.00
TEMP SERVICE, POLE, & APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE.
TEMP. POWER POLE
UNDERSLAe WORK
ROUGH CONDUIT
WIRING
PERMIT FEE (SUB TOTAL)
FIXTURES
PLAN CHECK FEE 150% PERMIT FEE)
POWER AUTHORIZED
PERMIT ISSUING FEE 2.00
UTILITY CO:NOTI FIED C
SUPPLEMENTARY PERMIT ISSUING FEE I.00 FINAL
TOTAL FEE 910 JOSEPH C. ROOHAN
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATIONCK. M.G. CASH PERMIT VALIDATION CK. M.0. CASH-
9 7.4 6� fn1Y 2 ' D �.�0 '
EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE