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76A663-CE806 9-67 QppUCAMN FOR E ILEC TPUC pE63MN
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION ADDRESS O/ �!/T�
JOHN A. LAMBIE, COUNTY ENGINEER
JENKINS, SUPERINTENDENT OF BUILDING /7� / /, I`
COLEMAN W. /•� T
i. LOCALITY � +,
FOR APPLICANT •TO FILL IN CROSS ST.
NO. EACH FEE
$ $ OWNER G� ��• !/� /Mor4�
RECEPT._ MAIL /��11 p/
LIGHT TOTAL FIRST 20 .20 ADDRESS 4o !-9 IV •
(, SWITCH_ OVER 20 .10 CITY ��� � C'� /TEL. NO.
?� LIGHTING 1 TOTAL FIRST 20 .20 CONTRACTOR
FIXTUREIS T OVER 20 .10 ADDREl,SS �G //,�/i/YD`��rdv�
RANGELDRYER_LWTR.HTR._ CITY✓0EL. NO.
STA.COOK DISP.-F.A.U.- LICENSE NO. 2 'y3 2 3a1%
SPACE HTR. AIR GOND. IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPL'I'CATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO'COMPLY
CLOTHES WASH._DISHWASH._ WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
FANOTHER 1.00 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
MOTORS,TRANSFORMERS RATING CALIFORNIA OR THAT I AM T LEGAL OWNER OF, NO END 70
IND. HEATERS, ETC: HP. KW. KVA. RESIDE IN, THE ABOV ESCRIBED R IDEN A OPERTY,.
SIZE & TYPE OVER TO SIGNATURE
0 - 1 1.00 OF PERMITTEE d
10 — so 5.00 DIST ICT N G MLP�E
r
50 - 100 10.00 1 NOTES:
W
100 - 500 15.00 N
TUBE, OR SIGN AND ONE CIRCUIT 3.00
r, MARQUEE ADDITIONAL CIRCUITS 1.00
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00
SERVICE OVER 600 VOLTS OR 200 AMP 5.00
S
TEMP SERVICE, POLE, &APPURTENANCES 3.00
S
APPROVALS DATE INSPECTOR'S SIGNATURE
N �sTEMP. POWER POLE
,. UNDERSLAS WORK
ROUGH CONDUIT
.. ISSUING FEE 2.00 lam(,/�?WIRING
r' FIXTURES -
SUPPLEMENTARY ISSUING FEE 1.00
�.�:POWER AUTHORIZED A n
PERMIT FEE ",UTILITYCO.NOTIFIED a
PLAN CHECK FEE (50% PERMIT FEE) FINAL ll�� A
TOTAL FEE -^e
JOSEPH C. ROOHAN
SUPERVISING EL RI AL ENGINEER
PLAN CHECK VALIDATION CK. M.C. CASH PERMIT VALIDATION CK M.O. CASH
iEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE J
76A663-CE80612-58 APPLICATION FOR ELECTRIC PERMIT 4
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING f
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A.LAMBIE,COUNTY ENGINEER
CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PERMIT FEES CROSS ST.
OWNER
ITEM NUMBER EACH FEE
OUTLETS•' _ $ S MAIL
LIGHTS RECEPT. W. "� .10 - ADDRESS -
pc
LIGHTING FIXTURES .10 CITY TEL.NO.
ELEC.RANGES CLO.DRYERS ELECTRICIAN
4 WATER HEATERS .50 ADDRESS ,
ELEC.SPACE HTRS. DISHWASHERS
CITY J-:r:' Imo' TEL.NO.
GARBAGE DISPOSERS AUTO.-
STATE
WASHERS STA,COOKING UNITS .25 LICENSE NO.
MOTORS: OVER INC. H.P. DISTRICT NO. 1GROUP'l ZONE 1PROCESSEDBY1
0— 1/2 .25 _ !r
1/2- 2 .50 INSPECTION RECORD
2— 5 1.00
5— 15 1.50
is— 50 2.50
50-200 5.00
SIGNS: NO.TRANS.
NO. LAMPS
SERVICE 0-600V 1.00
SERVICE OVER 600V 5.00
MISC.
WIRING PERMIT 1.00 --
FIXTURE PERMIT 1.00 ---
SUPPLEMENTARY PERMIT .50
TOTAL FEE $ 1 APPROVALS
IH
ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT
ELECTRICAL WIRING.
WIRING
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. POWER
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITTEE
FINAL
OF VALIDATION
CK MO CASH SUPERVISING ELECTRICAL ENGINEER