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DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERI4II�
COUNTY OF LOS ANGELES ELECTRIC
M. J. FOX CHIEF ENGINEER
Q NAME DISTRICT NO. GROUP I ZONE PERMIT NO.
La1 ADDRESS -
1) CITY TEL.NO. RECEIVED BY READY FOR DATE ISSUED
W J FIRST INSPECTION
J COUNTY
Id CERT.NO. EXPIRES
APPLICANT FILL IN HEAVILY OU'T'LINED PORTION ONLY
JOB
DESCRIPTION OF WORK ADDRESS
NUMBER OF OUTLETS ON CIRCUITS LOCALITY
LOCATION BY ROOMS NEAREST
LIGHT OUTLETS SW. PLUGS FIXT CROSS ST.
CIRCUIT A B C D E F. G H 1X NAME
J v Z MAIL
f 3 ADDRESS
O
CITY TEL.NO.
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF QUALIFICATION..
ELECTRICIAN.
I AM THE LWAL OWNER OF THE PROPERTY DESCRIBED
ABOYE
OWNER.
j CORRECTIOI7dS
J
Q
_Z
L7
D
TOTAL
NO. OF OUTLETS $ APPROVALS
NO. OF FIXTURES $ DATE IN TOR'S NAME
NO. OF MOTORS H.P. $ CONDUIT
NO. OF SIGNS TRANS. $ WIRING
NO. OF RANGES OR HEATERS $ FIXTURES
MISCELLANEOUS $ POWER
PERMIT FEE $ UTILITYCO.NOTIFIED
TOTAL FEE < FINAL,
DBS SA 11-46 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY ELEC'�RIC
COUNTY OF LOS ANGELES
69 ,"!
WM. J. FOX CHIEF ENGINEER
Z NAME
DISTRICT NO. GROUP I ZONE PE IT NO.
U ADDRESS
RECEIVED$Y READY FOR DATE ISSUED
CITY TEL.NO. "J� FIRST INSPECTION
J COUNTY
W CERT.NO. EXPIRES
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
JOB
(DESCRIPTION OF WORK ADDRESS
NUMBER OF OUTLETS ON CIRCUITS LOCALITY
LOCATION BY ROOMS NEAREST
LIGHT OUT SW. _PLUGSF)eT CROSS ST.
CIRCUIT A dB C D E F G H W NAME
Z MAIL
3 ADDRESS
O
CITY TEL.NO.
I AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF QUALIFICATION..
ELECTRICIAN.
I AM THE LEGAL OWNER OF THE PROPERTY DESCRIBED
ABOVE
OWNER.
CORRECTIONS
J
13
TOTAL
NO. OF OUTLETS $ APPROVALS
NO. OF FIXTURES $ DATE INSPECTOR'S NAME
NO. OF MOTORS H.P. $ CONDUIT
NO. OF SIGNS TRANS. $ WIRING
NO. OF RANGES OR HEATERS $ FIXTURES
MISCELLANEOUS $ POWER
PERMIT FEE $ UTILITYCO.NOTIFIED t
TOTAL FEE aS FINAL