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DeS.SA 3.55 APPLICATION FOR ELECTRIC PERMIT I
DIVISION OF BUILDING AND SAFETY
Depoximent of County Engineer 1
County of Los Angeles BUILDING 8853East HermosaWM.J. FOX, COUNTY ENGINEER ADDRESS
CASSATT D. GRIFFIN. SUPT OF BUILDING
LOCALITY Temple Cit
• FOR APPLICANT TO FILL IN NEAREST
PERMIT FEES CROSS ST.
NUMBER EACH I FEE /� p
OWNER /" /
LIGHT OUTLETS 19
RECEPTACLES 19 MAIL
ADDRESS
WALL SWITCHES 11
TOTAL OUTLETS 42 5£ S CITY TEL. NO.
ELEC. RANGES 25 ELECTRICIAN G. E Corbin
_ELEC. HEATERS 25 ADDRESS 1800 S. CUrtiS
KW EA C CITY A I hqrnhra TEL. NO U
FIXTURES 5 60. LICENSE NO. 21,32640,10
NUMBER OF LIGHT CIRCUITS
DISTRICT O. GROUP ZONE READY FOR INSPECTION
NUMBER OF RECEPTACLE CIRCUITS I Z) I ��/
MOTORS aa�i//
NUMBERHORSEPOWER I FEE INSPECTION RECORD
NEW MVD. HP OVER INC. EACH X—//—LTJ_ /// A/Nr- GQ� r /I.p �� [,• P
T• a ri
Ih a tEss s .25
h z so
z 5 1.00 c -r•/
isn,�
5 5 1.50
5 50 2.50 _
50 200 5.00
MISC.
NO.SIGNS NO.TRANS.
NO.SIGNS NO.LAMPS
FOR EACH PERMIT:
WIRING S1.00
FIXTURES 51.00 �_L 00
SUPPLEMENTARY .50 I APPROVALS
TOTAL FEE S 5L20 DATE INSPECTORS SIGNATURE
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION CONDUIT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING ELECTRICAL WIRING.
—2 41 HEREBY CERTIFY THAT 1 A R R STEREO AND/OR
LICENSED AS REO UIRED
BY G LES Al. STATE OF
CALIFORNIA OR THAT I AL OF THE ABOVE POWER
DESCRIBED RESIDENT.
UTILITY CO. NOTIFIED
SIGNATURE
OF PERMI FINAL l���0 �-
WILLIAM J. FOX.COUNTY ENGINEER VALIDATION A.C.VEIT.CHIEF ELECT. INSPECTOR
LAC04 4 3 41- 1N23 2 5.20 In