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76A663-CE606 5-62 APPLICATION FOR ELECTRI L PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING „! f
BUILDING AND SAFETY DIVISION ADDRESS V
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A.JENSEN, SUPT OF BUILDING LOCALITY l -
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
RECEPT. TOTAL NO. EACH FEE
OUTLETS FIRST 20 $20 $ qty OWNER
LIGHT MAIL
AOWL 10 ADDRESS %.
SWITCH. OVER 20
LIGHTING TOTAL (FIRST 201 .20 CITY TEL. N
FIXTURESI ADD'L 10 ELECTRIC( N
}
_ OVpR 20 /
RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS / /
GARB.DISP. STA.COOK CITY EL.
DISHWASH. AUTO.-WASH. STATE
SPACE HTRS. STA.APP.(l/z H.P.MAX.) ,50 LICENSE NO.
MOTORS: OVER NOT OVER H.P. DISTg1CT ROUP Z E P OC SE BY
O 1 1.00 1210
1 5 1.50 INSP I RECORD
3 a 2.00
}
8 15 .50 a
O
I SO 5.00 V
50 O 5.00 0
SIGNS: NO.TRANS W
NO.LAMPS
CL
N
SERVICE 0.60OV-NOT OVER 200A 1.00 Z
SERVICE 0.600V-OVER 200 A. 2.00
SERVICE OVER 600V 5.00
MISC.
PERMIT ISSUING FEE 2.00 u
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE $
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
I HEREBY CERTIFY THAT OPERLY E E D AND/OR
LICENSED AS REQUIRED L GELES UN STATE OF FIXTURES
CALIFORNIA OR THAT AM AL ER O T�;F ABOVE
DESCRIBED RESIDENTIA PRO POWER
SIGNATUREUTILITY CO.NOTIFIED
I OF PERMITTEE
FINAL
LIDATION ARTHUR C. VEIT
SUPERVISING ELECTRICAL ENGINEER
C MO CASH
I
Lij o7 4 0 5:o Nciv26 2 D !>A0- '
16A663-CE806 5-62 APPLICATION FOR ELECTRICAL/PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION - ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER 1,
WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY
NEAREST Z.
FOR APPLICANT TO FILL IN CROSS sT.
RECEPT, TOTAL NO. EACH FEE
L
IGHTOUTLETS FIRST 20 $20 $ OWNER
/ ADD'L /� n ADDRESS
AIL
6 OVER 20 �,J •1O /
TOTAL CITY TEL. N
G -r IFIRST20I/'� .20
ES } IV ADD'L 10 ELECTRICIAN
OVER 20
CLO.DRYERS WTR.HTRS. 1.00 ADDRESS
. / STA.COOK /
CITY TEL.NO.
AUTO.-WASH. STATE
. STA.APP.(ys H.P.MAX. _ ,50
LICENSE NO. /
MOTORS: OVER NOT OVER H.P. DISTRICT NO, GRQ P ZONE P lD B
O 1 1.00
1 3 1.so INSPECTION RECORD
3 8 2.00
8 15 2.50 }
a
15 50 3.00 u
50 100 5.00
O
SIGNS: NO.TRANS- U
NO.LAMPS W
SERVICE 0.60OV-NOT OVER 200A 1.00 N
SERVICE 0.600V-OVER 200 A. 2.0011
SERVICE OVER 600V 5.00
MISC.
PERMIT ISSUING FEE 2.00
SUPPLEMENTA13Y PERMIT ISSUING FEE 1.00
TOTAL FEE 8 6
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
L
TE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
L COUNTY ORDINANCES AND STATE LAWS REGULATING
AL WIRING. WIRING
BY CERTIFY THAT I AM PROPERLY REGISTERED AND/ORD AS RECUIRED BY LOS AN LES COUNT AND STATE OF FIXTURES 'RS"NIA OR THAT AM THE GAL O OF THE ABOVE
D RESIDENT P PERTY POWER e'
URE UTILITY CO.NOTIFIED. ++*-"MITTEE "' � -
FINAL }
VALIDATION A HUR C. VEIT
/
CK/` MO CASH SUPERVISING ELECTRICAL ENGINEER
L,' 9005-It3 JAN 2 2 D 16.4.0-
76A663-CE806 3-69
APPLICATION FOR �ECTRI_C`kl"PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER _
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY NEAREST
FOR APPLICANT TO FILL IN CRO S ST.
NO. EACH FEE �
$ $ OWNER
RECEIPT. MAIL
LIGHT TOTAL FIRST 20
CITY TEL.NO.
.20 ADDRESS
SWITCH OVER 20 .ip
PLAN CHECK
LIGHTING TOTAL FIRST 20 ,20 APPLICANT
FIXTURES } OVER 20 ,10 ADDRESS
RANGE_DRYER_WTR. HTR. CITY TEL. NO.
STA. COOK_DISP. _F.A.U. CONTRACTOR
SPACE HTR AIR COND. ADDRESS
CLOTHES WASH._DISHWASH. CITY TE L.NO
FAN OTHER 1.00 LICENSE NO. CLASS.
MOTORS,TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
IND. HEATERS, ETC. HP. KW. KVA. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
0 - 1 1.00 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATEOF }
I - 10 3.00 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. O
10 - 50 5.00 V
SIGNATURE '`
50 - 100 10.00 OF PERMITTEE OC
O
100 - 500 15.00 DISTRICT NO. G P ZOM RO ED BY U
61.7
SIGN,GAS SIGN AND ONE CIRCUIT 3.00 5 D y
TUBE, OR ^T
MARQUEE ADDITIONAL CIRCUITS 1,00 NOTES: "''�/I - / ( 0 � Z
SERVICE 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
UNDERSLAB WORK
ROUGH CONDUIT
WIRING
PERMIT FEE (SUB TOTAL) FIXTURES
POWER AUTHORIZED
PLAN CHECK FEE (50% PERMIT FEE)
PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED �*1
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL
I TOTAL FEE JOSEPH C. ROOHAN
SUPERVISING ELECTRLLAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
1 nn 6 L 6 6c it JG 4 2 0 3.8 Q�
SEE BACK OF APPLICATION FOR COMPLFTE FEE SCHFOIILF /•/^