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76.0663-CEh6 11-71'_71� �`w/-c U `TZ APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER TC
�
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN
.
OUTLETS N0. EACH FEE
OWNER Rl rj, 1;� L
RECEPT._I $ $ _`�.i ADDRESS Q
LIGHT TOTAL FIRST '10 •25 CITY �J 33 TEL. NO.
PLAN
SWITCH OVER 20 .10
C ECK
LIGHTINGTOTAL FIRST 20 .25 APPLICANT
FIXTURES
OVER 20 .101 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL. NO.
PERMIT
RANGE DRYER_WTR. HTR. APPLICANT
STA. COOK DISP. F.A.U. ADDRESS. aw
SPACE HTR. AIR COND. CITY TEL. NO.
CLOTHES WASH. DISHWASH. LICENSE NO. CLASS.
FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING.
SIZE & TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 - 1 1.00 LICENSED AS REOU IRED BY LOS ANGELES COUNTY AND STATE OF d
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO
1 - 10 3.00 RE91DE IN, THE ABOVE SCRI RESIDENTIAL OPERTY. V
SIGNATURE I -
10 - 50 5.00 OF PERMITTEE o
50 - 100 10.00
DItZRICT CLASS
ITE g PRO;�"
W
100 - 500 15.00 J a
t/1
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOTES: 1,Z//1 77 I!L[.�-�/ Z
TUBE, OR y.i
MARQUEE ADDITIONAL CIRCUITS 1.00
SERVI CENOT OVER 600 VOLTS OR 200 AMP 3.00
SERVICEOVER 600 VOLTS OR200AMP 10.00 APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP.POWER POLE
TEMP SERVICE,POLE,&APPURTENANCES 5.00
TEMP LIGHT OR RECEPT. SYSTEM 3.00 UNDERSLAB WORK
ROUGH CONDIUT
WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FEE (SUB TOTAL)
UTILITY CO. NOTIFIED
PLAN CHECK FEE
PERMIT ISSUING FEE 3AFI NAL
0 (r8
TOTAL FEE
PLAN CHECK VALIDATION SCK. M.0. CASH PERMIT VALIDATION CK. .O. CASH
LACO 7 ? 4 3�. UL 2 4 2 D 325-
SEE
25-
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
7BAB6a-CE6O6_11-322APPLICATION FOR ELECTRIC PERMIT 1
Gro= OF LOS )MELES
DEPARTMENT OF COUM ENGINEER BUILDING
SII�IIpA�ING AND SAMYp BDrMEON ADDRESS OT
CASSAIT / ajY
A GH>I 1N.SlVt Dt SW&S LOCALITY /
14EAREST
FOR APPLICANT TO FILL IN CROSS ST.
PEMT FEES
ITEM NUM13ERI EACH FEE OWNER
RS
OUTLET S $ MAIL
LIGHTS RECEPT. SW. .10 �. ADDRESS
LIGHTING FIXTURES ..Io CITY TEL.NO.
ELEC.RANGES CLO.DRYERS ELECTRICIAN
WATER HEATERS .50
ADDRESS
ELEC.SPACE HTRS. DISHWASHERS
.GARBAGE DISPOSERS �T�--- CITY TEL.NO.
W STA.COOKING UNITS ,25 STATE
LICENSE NO. Al
M TORS: OVER INC. H.P.
O— 1/2 .25 DIS RICT NO. GROUP N READY FOR INSPECTION
1/s— 2 .50
2 — s 1.00
INSPWTION SWORD.
5 — 1s 1.50
Is — so 2.50 farm--e�a
50— 200 5.00 a' / �.JL.CI r•
SIGNS? NO.TRANS. r
NO.LAMPS - -
SERVICE 0-000V 1.00 r
SERVICE OVER SOOV 13.00
MISC.
t
WIRING PERMIT 1.00
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT .50
TOTAL FEE g APPROVALS
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO .COMPLY CONDUIT r
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING y, 1[4-4,. :TVA
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS.REQUIRED BY LOS ANGELES QQUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT M -WHE GA OWNER OF TH BO POWER
DESCRIBED RESIDENT OPER
SIGNATURE UTILITY CO.NOTIFIED
OF.PERMITTEJd
- ,�•.,. � FINAL
VMMATI~ ARTIH UR
N6 EL60TRICAL ENGINEER
CK MO SH
7SA1363.CESOB7•BB APPLICATION FOR ELECTRIC PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION
JOHN A. LAMBIE, COUNTY ENGINEER
CASSATT D. GRIFFIN,SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PERWr FEES cRoss sr.
I T E M NUMBER EACH REE OWNER
OUTLETS: $ $ MAIL.
LIGHTS 'RECEPT. 8W. .10 ADDRESS
LIGHTING FIXTURES .10 CITY TEL—NO.
ELEC. RANGES CLO. DRYERS ELECTRICIAN
W A T E R HEATERS •50 ADDRE
ELEC SPACE HTRS. DISHWASHERS
CITY TEL. NO.
GARBAGE DISPOSE AUTO.- -
STATE
WASHERS STA. COOKING UNITS .26 LICENSE NO. D
MOTORS: OVER INC. H.P. tommDI 0. P N% P CESS: Y
ol
0— +/a 25
+ia— 2 .50 INSPECTION RECORD
2— 5 1.00
5— 15 1.60 W.
is— 50 2.50
150-200 5.00
SIGNS: NO. TRANS.
NO. LAMPS
SERVICE 0-60OV 1.00
SERVICE OVER 60OV 5.00
M ISC.
WIRING PERMIT 1.00 Q .
FIXTURE PERMIT Loo s
SUPPLEMENTARY PERMIT .50
TOTAL FEE - $ APPROVAIS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE INSPE OR'8 SIGNATURE
AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY 'CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING _
ELECTRICAL WIRING. .e. WIRING
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOG ANGELES COUNTY AND STATE OF .FIXTURES
CALIFORNIA OR THAT 1 AM THE L OWNER OR THE OVE ..
DESCRIBED RESIDENTIA PE POWER
SIGNATURE UTILITY CO.NOTIFIED /
OF PERMITTEE FINAL-
VAMATIMN SU ERVISING El CTHUR C. TRICAL ENGINEER
CK NO• CASH
42539; VAR 30 2 A' 125 �