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70A689-CE908 10-e9 APPLICATION FOR ELECTRIC P T
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION FAABDDUDRESS
/i vJOHN A. LAMBIE. COUNTY ENGINEERWILLIAM A.JENSEN,SUPT OF BUILDING ALITY
FOR APPLICANT TO FILL IN NEAREST
PERNIIT FEES CROSS ST.
C Z:-
ITEM NUMBER OWNER EACH FEE MAIL
OUTLET f f ADDRESS
LIGHTS RECEPT. SW. / .10
LIGHTING FIXTURES 10 ii CITY / 4 TEL.NO.
ELEC.RANGES CLO.DRYERS ELECTRICIAN / F ✓"
I
WATER HEATERS .50 ADDRESS e -
ELEC.SPACE HTRS. DISHWASHERSCITY TEL. NO. I i
GARBAGE DISPOSERS AUTO.- STATE
WASHERS STA.COOKING UNITS .25 LICENSE NO.
MOTORS: OVER INC. H.P. DISTRICT GROUP CNP D
7 o— 1/2 Xr .25
1/2- 2 .50 INSPECTION RECORD
2— 5 1.00
5— 15 1.50 G
15— SO 2.50
50—200 5.00
SIGNS: NO.TRANS. e
NO.LAMPS
SERVICE 0-600V 1.00 G�
SERVICE OVER 600V 5.00
MISC.
WIRING PERMIT 1.00 C v
FIXTURE PERMIT 1.00 `(1
SUPPLEMENTARY PERMIT .50
TOTAL FEE f
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS 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.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR WIRING
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE (/
DESCRIBED RESIDENTIAL P OPERTY. POWER
SIGNATURE ;v�iir
/�i� UTILITY CO.NOTIFIED
OF PERM Il j'
FIN
mrgRTHUR C.VETT,
CK MoO CASH CASH UPERVISIN6 ELECTRICAL ENGINEER
X05 0 3 0 -1.5' 7 2 D 7.95
44,%,663 DBS 5A 7-51 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY ELECTRIC i
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
F ANT I I DISTRICT NO. GROUP I ZONE PERMIT NO.
ELECTRICIAN --
740 RECEIVED BY READY FOR DATE ISSUED
ADDRESS FIRST INSPECTION _
CITY EL MONT L �rg�
TENO.
COUNTY LICENSE NO. EXPIRES BUILDINO
PERMIT FEES ADDRESS
FEE
NUMBER EACH LOi�CALITY f U
LIGHT OUTLETS NEARESTST.
f ~'
CRO 8 B l✓
RECEPTACLES LL/j qA 11�\
WAIL SWITCHES OWNER r 1`(f`1 �-' I` ,M O _
TOTAL OUTLETS ; 5. V) 46A.0- G" 1 I 7 S C-
ELEC. RANGES 25 APPEMESS j ! i 3 v-- -,—r" l'--,
HEATERS 25 CITY TEL. NO.
FIXTURES 5 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 HORSEPOWERFEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
NEw Mvo. HP DvER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
.pll V2 6 LESS $ .25 ,`.a .•� '
SIGNATURE OF p
%2 2 .50
PERMITTEE
2 5 1.00 - IN PECTION RECORD
5 15 1.50
_ 15 50 2.50
50 200 5.00 1 y J Z
200 500 10.00 J
500 1 000 15.00 Z
r E N •-s
OVER 1000 20.130 �
M.G. SET/FREQ. CHAN13ER-HP T" .�'�- �"`''•"�F� �'!� r---�� "
WELDERS:AC-KVA O
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75% OF ORIG.)
MOVED MOTORS (75% OF DRIG.)
misc.
SIGNS
NO. NO.TRANS.
APPROVALS
NO. NO. LAMPS
DATE INSPECTOR'S NAME
FOR EACH PERMIT:
WIRING $1,00 CONDUIT
FIXTURES $1,00 WIRINGSUPPLEMENTARY .50.50 FIXTURES
1� POWER
TOTAL FEE �- !Q UTILITY CO.NOTIFIED
FINAL
I
76"" O98SA 11-49 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES ELECTRIC 1
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO L IN DISTRICT NO. GROUPJ ZONE PERMIT NO.
ELECTRICIAN
IVED, BY READY FOR DATE IYBUEO
ADDRESS .� FIRST INSPECTION
CITY TEL.NO k A-
COUNTY LICENSE NO. EXPIRES BUILDING /7 7D � LIOW6 ' A ' 1 P*
PERMIT S ADDRESS `� /�G�/ ��
NUMBER OUTLETS EACH FEE LOCALITY o -
rc
LIGHT 5C $ NEAREST
CROSS ST.
RECEPTACLES 5
FIXTURES 5 OWNEiZ '
WALL SWITCHES 5 MAIL }
ELEC. RANGES 25
ADDRESS
ELEC. HEATERS 25 CITY - EL. NO.
MISC. 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
NUMBER OF CIRCUITS INSTALLED:
TOTAL APPLICATION AND STATE THAT THE ABOVE IS CORRECT
LIGHTS RECEPTACLES AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
MOTORS AND STATE LAWS REGULATING ELECTRICAL WIRING.
NUMBER HORSEPOWER FEE I CERTIFY. THAT I POSSESS THE ABOVE VALID LOS
NEW MVD. HP OVER INC. EACH ANGELES COUNTY LICENSE, OR 1 AM. THP, LEGAL OWNER
!/2 & LESS $ .25 OF THE RESIDENTIAL PROPERTY DESC CD IAABOVE. F
V2 2 .50 SIGNATURE OF
2 5 1.00 PERMITTED
5 15 1.so INSPECTION RECORD
is 50 2.50
50 200 5.00
200 500 10.00
500 1000 15.00 A
OVER 1000 20.00 Z
M.G. SET/FREQ. CHANGER-HP 9
WELDERS: AC-KVA Q!
"GE ERATORS - KW ( 0
TEMP. MOTORS (75% OF CRIB•)
O
MOVED-MTORS (75% of own.)
MISC.
SIGNS
-fYPE: O.TRANS. 042,
TYPE: 10�0 .13. LAMPS I APPROVALS
FOR EACH PERMIT: DATE INBPECTOR•S NAME
WIRING $1.00 CONDUIT
FIXTURES $1.00 WIRING
SUPPLEMENTARY .50 FIXTURES
n� POWER
TOTAL FEE $� UTILITY CO.NOTIFIED
FINAL �� 1✓ �).c
76ASS3 DBS SA 25M SETS 11-48 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY ELECTRIC 1
COUNTY OF LOS ANGELES
WILLIAM J. FOX CHIEF ENGINEER
DISTRICT NO. GROUP ZONE ERMIT NO.
FOR APPLICANT TO FILL IN GI
ELECTRICIAN ^ co RECEIVED BY READY FOR DATE ISSUED
FIRST INSPECTION
ADDRESS sC
CITY TEL. NO. JrA2 0 L/
BUILDING )
LICENSE NO. EXPIRES ADDRESS O we v-'
DESCRIPTION OF WORK
NUMBER I OUTLETS EACH FEES LOCALITY �L
LIGHTS Sc $ CROSS
STREET iA orT O E'1P
RECEPTACLES 5
FIXTURES 5
OWNER t
WALL SWITCHES 5 MAIL
ADDRESS
ELEC. RANGES 25
ELEC. HEATERS 25 CITY TEL. NO.
MISC. 1 CERTIFY THAT i POSSESS THE ABOVE VALID LOS
NUMBER OF CIRCUITS INSTALLED: ANGELES COUNTY LICENSE.
LIGHTS RECEPTACLES , R. - •C__r���
MOTORS
ELECTRICIAN.
NUMBER HORSEPOWER FEE
NEW Mvo. HP OVER INC. EACH
I AM THE LEGAL OWNER OF THE RESIDENTIAL PROP-
!/2 6 LESS $ .25 ERTY DESCRIBED ABOVE.
%z 2 .50
2 5 1.00 OWNER-
5 15 1.50 INSPECTION RECORD
15 50 2.50
50 200 5.00
200 500 10.00
SOO 1000 15.00 J
Q
OVER 1000 20.00 _Z
M.O. SET/FREQ. CHANGER-HP I 0
WELDERS: AC-KVA O
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75% OF ORIG.)
MOVED MOTORS (75% OF ORIG.)
MISC.
SIGNS
TYPE: NO.TRANS.
TYPE: NO. LAMPS APPROVALS
PERMIT FEE DATE INSPECTOR'S NAME
FOR ISSUING PERMIT: CONDUIT
WITHOUT FIXTURES $1x00 WIRING
WITH FIXTURES 1.25 FIXTURES
SUPPLEMENTARY .50
POWER
TOTAL FEE $ UTILITY CO. NOTIFIED
FINAL ' �1
i
r
76A66C-CE#806 5-67 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS /ANGELES
DEPARMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER 4
WILLIAM A.JENSEN,SUP'T OF BUILDING LOCALITY ?!� I
NEAREST
FOR APPLICANT TO FILL IN CROS-
PERMIT FEES OWNER
1 T E M NUMBER EACH FEE MAIL
ADDRESS
OUTLETS: $ $
LIGHTS RECEPT. SW. .lO CITY TEL. NO. -�
LIGHTING FIXTURES .10
ELEC. RANGES CLO. DRYERS ELECTRICIAN `(
WATER HEATERS .50 ADDRESS ')
ELEC.SPACE HTRS. DISHWASHERS
CITY �7 c
TEL NO.
GARBAGE DISPOSERS AUTO.- STATE -+�•
WASHERS STA.COOKING UNITS .25
LICENSE NO. �GG/L� � d
MOTORS: OVER INC. H.P. DIST CT NO. JG�QUPJ ZZQNE P ESSED BY _
lie— 2 .50 :. INSPECTION RECORD
2— 5 1.00 r r% O
5— Is 1.50v ° v
15— 50 2.$O OC
50— 200 O
$.00 W
NO TRANS. d
SIGNS: NO.LAMPS ,Z
SERVICE 0.600V 1.00
SERVICE OVER 600V 5.00
misc.
WIRING PERMIT
FIXTURE PERMIT ,00
SUPPLEMENTARY PERMIT 50
TOTAL FEE
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
WIRING /Y"� ,✓°'a"-
1HEREBY CERTIFY THAT I 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 T 6 ABOVE
DESCRIBED ENTIAL PROPERTY. POWER
SIGNATUR
1
OF PERMITTEE
��� LITYCO.NOTIFIED /
FINAL .
VALIDATION ARTHUR C. VEIT
CK MO (CASH SUPERVISING ELECTRICAL ENGINEER
76A663 1395 SA 25M SETS 11-46 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY ELECTRIC 1
COUNTY OF LOS ANGELES
WILLIAM J. FOX. CHIEF ENGINEER
DISTRICT NO. GROUP I ZONE PERMIT NO.
FOR APPLICANT TO FILL IN (— 6�. 1
ELECTRICIAN C d REC" BY READY FOR DATE ISSUE
ADDRESS r--
/ FIRST INSPECTION f
/ !
CITY \ TEL. NO.
BUILDING
LICENSE N0. & se EXPIRES ADDRESS
7-!a-
DESCRIPTION OF WORK
FEES LOCALITY If C
NUMBER ( OUTLETS EACH
CROSS
LIGHTS 5c $ STREET tl
RECEPTACLES 5
FIXTURES 5 ]OWNER 'C yj C Y
WALL SWITCHES 5 MAIL
ADDRESS
ELEC. RANGES 25
ELEC. HEATERS 25 CITY TEL. NO.
MISC. 1 CERTIFY THAT 1 POSSEBB THE ABOVE VALID LOS
NUMBER OF CIRCUITS INSTALLED: ANGELES COUNTY LICENSE.
LIGHTS RECEPTACLES
MOTORS
ELECTRICIAN.
NUMBER HORSEPOWER FEE
NEW MVO. HP OVER INC. EACH _ 1 AM THE LEGAL OWNER OF THE RESIDENTIAL PROP-
!/2 6 LESS $ .25 L J ERTY DESCRIBED ABOVE.
1 %2 2 .50
2 5 1.013 OWNER.
5 15 1.513 INSPECTION RECORD
15 50 2.50
50 200 5.00
200 500 10.00
!!.Do 1000 15.00
Q
OVER 1000 20.00 _Z
M.G. SET/FREQ. CHANGER-HP I m
!Y
WELDERS: AC-KVA O
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75% OF ORIG•)
MOVED MOTORS (75% 13F ORIG.)
MISC.
SIGNS
TYPE: NO.TRANS.
TYPE: NO. LAMPS APPROVALS
PERMIT FEE DATE INSPECTORIS NAME
FOR ISSUING PERMIT: /^l CONDUIT
WITHOUT FIXTURES $1.00 I V v WIRING
WITH FIXTURES 1.25 FIXTURES
SUPPLEMENTARY .50
POWER
TOTAL FEE $ UTILITY CO.NOTIFIED
FINAL
i
COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department OF of CountBUILDING
EngineerFELECTRIC DIVISION OF BUILDING & SAFETY
WILLIAM J FOX County Engineer
FOR APPLICANT TO FILL IN DISTRICT GROUP I ZONE PERMIT NO
PKA1 (22 e
ELECTRICIAN
tVK I RE V BY READY FOR FIRST IINNJSPECCjT�pN DA+9 ISSUED
ADDRESS �
CITY jFL JTE TEL.NO
COUNTY LICkNSE NO EXPIRES BUILDING �}
PERMIT FEES ADDRESS (/
FEE
NUMBER EACH LOCALITY
LIGHT OUTLETS NEAREST
RECEPTACLES CROSS 61T
WALL SWITCHES OWNER
TOTAL OUTLETS Sc S MAIL
ELEC RANGES 25 ADDRESS
ELEC HEATERS 25 CITY TEL NO
FIXTURES 5
1 N REBY ACKNO EDGE 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 WIPING
MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER
NEW MVD HP ovER INC EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
S, LEGS S 25 SIGNATURE Or
I/ 2 So PERMITTER —
2 5 100 INSPECTION RECORD
5 15 ISO
is so 250
so 200 5 OO
200 6093 19300 J
500 10DO 1500 Z
OVER 113130 20 00 0
M G BET/FREQ CHANGER HP M
WELDERS AC KVA O
GENERATORS - KW
TRANSFORMERS KVA
TEMP MOTORS (75% DF CRIG)
MOVED MOTORS (75% OF CRID)
M18C
SIGNS
NON TRANS. ' Ar►
NO NO LAMPS V APPROVALS
FOR EACH PERMITS DATE INSPECTOR'S NAME
WIRING SIOD CONDUIT
FIXTURES 111100 WIRING
SUPPLEMENTARY_ 50 FIXTURES
POWER
TOTAL FEE S UTILITY CO NOTIFIED
FINALvL�
T8A888 DBS.#5A 4 52
WORK R S COMPENSATION DECLARATION 726AN39 DPW(72 91) APPLICATION FOR ELECTRICAL PERMIT
I hereby Affirm that I have a certificate of consent to self Insure 'd
or a certific4te of Worker s Compensation Insurance or a certified COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV
copy thereof(Sec X800 Lab C)
Policy NO Company CqW FOR APPLICANT TO FILL IN JOB
ADDRESS
Certified copy is hereby furnished 21 4.41H
New Residential Bldgs &Pools NO EACH FEE LOCALITY
7-44"40 MIA4
LTJ__Certified co is filed with the county building inspection 1 &2 Family Sq Ft — $ $
Py ty 9 P _ NEAREST
departme t Multifamily Sq Ft CROSS ST
Date Applicant 1A Cx Residential Swimming Pools ASSESSOR
MAP BOOK PAGE PARCEL
CERTIFICATE OF EXEMPTION FROM WORKERSOWNER OR
COMPENSATION INSURANCE Outlets Rec _Light SW ' aO FIRM NAME
First 20 O MAIL
(This section need not be completed if the work Involved by the Total No �_ Additional ADDRESS
permit is for one hundred dollars($100)or less)
I certify that in the performance of the work for which this permit CITY T I No
is Issued I shall not employ any person in any manner so as to PLAN CHECK
become subject to the Workers Compensation Laws Lighting Fixtures First 20 APPLICANT
Total No Additional ADDRESS
Date Applicant RESIDCNTIAL APPLIANCES NOT OVER 3 HP
NOTICE TO APPLICANT if after making this Certificate of CITY Tel No
Exemption you should become subject to the Workers Compensation OTHER APPLIANCES NOT OVER 3 HP
provisions of the Labor Code you must forthwith comply with such PERMIT
provisions or this permit shall be deemed revoked
Power Apparatus&Large Appliances APPLICANT V
LICENSED CONTRACTORS DECLARATION Size&Type HP KW KVA or KVAR ADDRESS
I hereby affirm that I am jicensed under provisions of Chapter 9 Over 3 to 10 Incl
(commencing with Section 7000) of Division 3 of the Business and CITY eI o
Professions Code and my license Is in full force and effect Over 10 to 50 Incl }
LICENSE OR / Claw
ss
�`1 X� Over 50 t0 100 Incl REG NUMBER / d
�v //� I �D�/ Over 100 DISTRICT NO P C ED BY U
License Number . Lic Class (y
Services Swbd MCC&Panelboards �dG I=
Contractor /at. 0 399 Amp Under 600 V FINAL DATE q I_400 1000 Amp Under 600V S
5_2 1 / VALIDATION V
I am exempt under Sec Over 1000 Amp or Over 600 V FINAL OW.
B&P C for this reason BRANCH CIRCUIT FEES BY
Date 15A or 20A 120V Lighting or Recept Z_
1 To 10 Branch Circuits
Signature 11 To 40 Branch Circuits
41 Or More Branch Circuits
Exemption for Reg Maint Elect 15A 20A 208V To 277V Lighting Br Circuits 2
SINGLE FAMILY Temp Power Pole&Appurtenancesf ACCT.1r
HOME OWNER BUILDER DECLARATION Sign with One Branch Circuit 1j
I hereby affirm that I am exempt from the Contractors License Law
for the following reason (Section 7031 5 Business and Professions Additional Sign Branch Circuits 6,,07 34■65
Code) ITEMS
I as owner of the property will do the work and the structure
Mlsc Conduits&Conductors 1
is not Intended or offered for sale(Section 7044 Business Other(See Complete Fee Schedule) , TOTAL. 34.65
and Professions Code) CHECK 34.65
CONSTRUCTION LENDING AGENCY CHANGEn�l
I hereby affirm that there is a construction lending agency for the
performance of the work for which this permit is issued(Sec 3097 PERMIT FEE (Sub-Total)
Civ C)
Lender s Name PLAN CHECKING FEE 0000_WO1 5/ 4/9s
M�r
PERMIT ISSUING FEE 9534 1 AM11:16
Lender s Address
I certify that I have read this application and under penalty of puqury state TOTAL FEE
that the above information is correct I agree to comply with all County
ordinances and State laws regulating Electrical wiring and hereby authorize
representatives of this County to ante upon the above-mentioned property
for inspe ti purposes SEE REVERSE FOR EXPLANATORY LANGUAGE
SIGNATURE MITTEE DATE