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76A663 DBS SA 11-60 - APPLICATION FOR PERNIIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES ELECTRIC '1
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO.
ELECTRICIAN �it V 6 0 f3,C + r7 7
RECEIVED BY READY FOR DATE ISSUED
ADDRESS �/Z U J G-L.L. k, - A FIRSTT-INSPECTION �''�
CITY /,L. h TEL. NO /,/ 1 � FI` '}.// �'T SSS/ 7 ��613/ '-+
COUNTY LICENSE NO EXPIRES V UILDING
PERMIT FEES ADDRESS
FEE LOCALITY
'NUMBER EACH '
LIGHT OUTLETS NEAREST
CROSS ST
WALL SWITCHES - OWNER
f �
TOTAL OUTLETS .gqy% ..Is / MAIL
ELEC. RANGES 25 ADDRESS
ELEC. HEATERS 25 CITY TEL. NO.
FIXTURES S 1 HEREBY ACKNOWLEDGE 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 1 CERTIFY THAT 1 POSSESS, THE ABOVE VALID LOS
NUMBER HORSEPOWERANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
FEE
NEW MVO HP OVER INC. EACH OF THE RESIDENTIAL PR PERTY DESCRIBED ABOVE.
1/2&LESS $ .25 SIGNATURE OF
1/2 2 .50 'PERMITTEE-
2 5 1.00 INSPECTI N RECORD Cl
5 15 1.50
15 50 2.50
5o 200 5.00
200 500 10 oo J
500 1000 1s 00 Z
OVER 1000 20 00 V'
M G SET/FREQ. CHANGER-HP O
WELDERS AC-KVA
GENERATORS-KW
TRANSFORMERS-KVA '
TEMP. MOTORS•(75%OF ORIG.)
MOVED MOTORS 7 (75/J%OF�+ORIGG)cy.
MISC /5 ���17�J / G)TSO L- %s
SIGNS
NO. NO.TRANS. I APPROVALS
NO NO LAMPS
DATE INSPECTOR'S NAME
FOR EACH PERMIT- `
,t CONDUIT /
WIRING $1 00
FIXTURES $1 ,00 WIRING •t 1� r""�.I( 1 s�"'
SUPPLEMENTARY .50 FIXTURES
POWER
TOTAL FEE $ UTILITY CO NOTIFIED lL/$ L
v —
�® FINAL