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COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department of County Engineer ell
DIVISION OF BUILDING & SAFETY E L �
WILLIAM J. FOX, County Engineer'
FOR LIC NT ILL IN DISTRICT NO. GROOUUP ZONE PERMIT NO.
raELECTRICIA , — 1 —/ �� —
RECEIVE BY READY FOR DATE ISSUED
ADDRESS //' ,{�rJ� FIRST INSPECTION
CITY TEL. NOwox
COUNTY 712 LICENSE NO. EXPIRES '� BUILDING �a
PERMIT E ADDRESS
FEE
NUMBER EACH LOCALITY
LIGHT OUTLETS NEAREST
CROSS ST, w
RECEPTACLES
WALL SWITCHES
TOTAL OUTLETS 5C $ IeV MAIL
ELEC. RANGES 25
ADDRESS /
ELEC. HEATERS 25CITY TEL. NO.
FIXTURES 5 61L
1 HEREBY ACKNOWLE E THAT 1 HAVE READ THIS
MISC. 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 CERTIFY THAT I POSSESS THE ABOVE VALID LOS
NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
NEW MVD. HP OVER INC' EACH OF THE RESIDENTIAL/PROPERTY 'ESCRI ED VE.
_ 1/2 6 LESS $ .25 SIGNATURE OF /
_ %2 2 .50 PERMITTEE
2 5 1.00 INSPECTION RECORD
5 15 1.50
15 50 2.50
5O 200 5.00
200 Soo 10.00 J
500 1000 15.00 Q
Z
OVER 1000 20.00
M.G. SET/FREQ. CHANGER-HP
WELDERS:AC-KVA O
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75% DF ORI®.)
MOVED MOTORS (7S% OF DRIG.)
MISC.
SIGNS
NO. NO.TRANS.
APPROVALS
NO. NO. LAMPS
FOR EACH PERMIT: DATE INSPECTOR'S NAME
WIRING $1.00 /� CONDUIT
FIXTURES $1.00 WIRING /FIXTURES IVY
L�+�' ,,,r .e•-/Iy'�"'c'
FA n 41
SUPPLEMENTARY .50 I
POWER `ry 1 Y �_
TOTAL FEE s
UTILITY CO.NOTIFIED
FINAL ,
I� .✓
76A663 DBS#SA 2-53 I
a COUNTY OF LOS ANGELES — APPLICATION FOR PERMIT '~
DEPARTMENT OF COUNTY ENGINEER
DIVISION OF BUILDING & SAFETY
WILLIAM 1. FOX, COUNTY ENGINEER
FOR 'SAN T F 'L IN ISTRiCT NO. GROUP ZONE PERMIT NO.
ELECTRICI'A
ADDRESS RECEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION
CITY ELI. NO. 1 u• i .•
COUNTY L CENSE NO. - EXP RES �� gU1LDING
PER FEES ADDRESS
NUMBER EACH FEE LOCALITY 00,
LIGHT OUTLETS NEAREST
RECEPTACLES MSS ST.
WALL SWITCHES OWNER
TOTAL OUTLETS Sc $. O
MAIL
ELEC. RANGES - 25 ADDRESS ; 11 r" !
ELEC. HEATERS 25
FIXTURES 5 CITY. / + TEL. NO.
MI C. I" HEREBY ACKNOWLED THAT I HAVE READ THIS
NUMBER OF LIGHT CIRCUITS APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING.
MOTORS I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
NUMBER HORSEPOWER FEE ANGELES COUNTY LIC NSE, OR 1 AM THE LEGAL OWNER
NEW MvD. HP OVER INC. EACH OF THE RESIDENTIA ROPERTY SCRIBE A OVE.
I/z BLESS $ .25
SIGNATURE OF
1/2' :2 .50. PERMITTE
2 5 1.00
5 15 1.50 INSPECTION RECORD
'15 50 2.50
50. 200 5.00
200 500 10.00.
500 1 1000 15.00 Q
Z
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.)
MISC.
F SIGNS C
NO. NO. TRANS. APPROVALS
NO. NO. LAM
FOR EACH PERMIT: DATE INSPECTOR'S NAME
WIRING .$I.00 ('. CONDUIT -
FIXTURES $1.00 WIRING
SUPPLEMENTARY .50 FIXTURES
POWER
TOTAL FEE $: / !b UTILITY CO. NOTIFIED
r
FINAL
75A 889 DBS# '5A. 4-52
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