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76A�663-CE80611-��. APPLICATION FOR ELECTRICAL PERMIT
'COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER FADDRESS
BUILDING AND SAFETY DIVISION ��7 0 / Q -u
C y,�- l (f1
FOR APPLICANT TO FILL-IN CROSS ST. F S i'1.+� -L ..'L 0ILIA-
OUTLETS NO. EACH I FEE I
OWNER
RECEPT._ $ Is
FIRST 20 ,r� ; ADDRESS O
LIGHT � TOTAL •25 �i
'17OVER 20 CITY TEL. NO.
SWITCH f0 PLAN CHECK
LIGHTING TOTAL FIRST 20 Z_ .25 I APPLICANT
FIXTURES
OVER 20 ADDRESS
� .10• 1
RESIDENTIAL APPLIANCES CITY } TEL. NO.
RANGE DRYER_WTR. HTR. APPMICANT a'7M e O L`J.
STA. COOK DISP. F.A.U. ADDRESS, ? J GIS" ,✓� �.a
SPACE HTR. AIR COND. CITY1 e—r,,..-e j ,K TEL. N0. . ...qa
� ,e
CLOTHES WASH. DISHWASH. LICENSE NO. G2— CLASS.(��
FAN OTHER 1.00 1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS 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 REQUIRED BY LOS ANGELES COUNTY.AND STATE OF.
CALIFORNIA OR THAT I AM-THE LEGAL OWNER OF, AND INTEND TO
I - 10 3.001 I RESIDE IN, THE=AI ) IDEN�I¢L� PROPERTY. 0SIGNATURE ����////
10 - 50 5.00 OF PERMITTEE_ O
50 - 100 10.00
DISTRICTNj CLASS ZONE P SS D BY ri
Lu
100 - 500 15.00 5,09 1 d
SIGN, GAS ESIGN AND ONE CIRCUIT 5.00 NOTES:
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00
SERVICE NOT OVER 600•VOLTSOR200AMP 1 3.00
APPROVALS DATE INSPECTOR'S SIGNATURE
SERVICE OVER 600 VOLTS.OR 200 AMP 10.00
I TEMP.POWER POLE
TEMP SERVICE,POLE,&APPURTENANCES 5.00
UNDERSLAB WORK
kPERMIT
OR RECEPT. SYSTEM 3.00
ROUGH CONDI UT
WIRING C� 7jiYezeth
FIXTURES
4 POWER AUTHORIZED
(SUB TOTAL)
UTILITY CO. NOTIFIED
FEE
FINAL
ING FEE 3.00
TOTAL FEE
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIO CK. ` M.O. CASH
6 0 2. 2 2 D . . 8.75-
SEE
• 8.75-SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
I
MUSTY DE LOS AMOBLE5 ' APPZ.ZCi►T= FM PST
a� ELECTRIC 1
WILLIAM L FOX. Ossaft KO/IOar '
FOR APPLICANT TO FILL IN DISTRICT NO. OROUP I ZONE PERMIT NO.
ELECTRICIAN A
�- MKOXIVED ■Y READY rOR DAT! ISSUED
ADDRESS
s+- �? vs• FIRST IH■PEOTION
CITY 1 r-7 �i TEL.No. 0 I ,y 3f•�'�� �'��
COUNTY LICENSE NO6 jf ccPIR!■ rA■DUDR I�NM7�� ,�D
PERwT FSS
HUMMER EACH SS! Lo13AL17Y
LIMHT OLITLLTS I NEAREST
R606PTAOLK■ RO
WALL MWITOHK■ OWNER b• ".'G
TOTAL OUTLETS do MAIL
ELKIL SANS!■ SS ADDNM
ILEO. HEATERS M5 CITY TEL. N0.
FIXTURES d
1 NlRKSY AOKNOWLEDME THAT 1 NAYK READ TNI■
MISO. f APPLICATION AND RAT! THAT THE ASCVK In CORRECT
NUMBER Or LIGHT OIRCUIT■ +7• j►ND AMR!! TO COMPLY WITH ALL COUNTY ORDINANOE■
MUMMER Or REOEPTAOLE CIRCUITY! AND STATE LAWS REMULATINM ELECTRICAL WIRING.
MOTORS I OENTIrY THAT 1 POSSSS■ THE AMOVE VALID LOM
RUMORS NOMEPMMR rum AN■RIES COUNTY LICENSE, OR 1 AM THE LZMAL OWNER
NM MvD. HP CURS IND. RAD" Or THE RESIDENTIAL PROPER;7-�n
RISED AMOVE.
VM IL IiaO .!d SIMNATUR! Or '� ` �ti
S .50 PlNNITTEK ••' ,
■ s 1.013 131 TM IU=Rn
d 10 1.80
15 SC M.OU
s0 MOO d.00
ROD ROD 10.00 J
5013 1 000 10.013 4c
Z
OVER IOOO I MCLOO 0
MA. ■R FR CHANCES-NP
WELDIRMI AC-KVA 0
REMERATOR■ - KW
TRANOrORMKRO - KVA
TEMP. MOTORS or DSIOa
MOVED MOTORS 175 or oSIOJ
1■
BIONS
NCL NO.TMANS. 11PPSOVALB
MIL NCL LA P■
ran KAON PKRMITI DAT! IN■PECTOR7 NAME
WIRINM suno CONDUIT
FIXTURES 97,00 r'A WIRINM
JNM2WW!N MY ,513 —� rIXTUMEM
OWIER
TOTAL FEE 0 UTILITY OCL NOTIrIIED I -n
FINAL
UAM DHS*R 44M ,�
Sl
GAGA!1 yr
'GA683 CE-Eb616%78) APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES ;' BUILDING AND SAFETY
FOR APPLICANT TO FILL IN JOB 10709 1'1J..lJDtiM
New.Residential'Bldgs.&Pools EACH - N061 FEE ADDRESS..
1 &2-Family,Sq.Ft. $ :025 — $ LOCALITY TEVM
Mul.t.i.#amilyScl,Ft, .02 — NEAREST
Residential Swimming Pools 25.00 . CROSS" OWNER .
FIRM NAME Hs R_ =
Outlets:.Rec . . Light. Sw.; MAIL
first 20 .50 (: ADDRESS SAME
Total No. Additional .30' 1 CITY Tel.(Vo. _
PLANCHECK
APPLICANT
Lighting Fixtures First 20 .50 . ADDRESS
Additional 30.
Total No. CITY Tel.No.
Fixed:ApplioncesNot Over•1 HP PERMIT
HCG
Range_Heater_D.W:—
APPLICANT
Oven—Dryer—W,M. ADDRESS_ • 2034.N. .PEC RD.
Top. _FAU 1Z_W.H._ CITY ;Sa M Tel:No579,7982
Hood=Fan _Other_ LICENSE OR
Disp.'—RoornA'irCond. 2.50 2 REG.NUMBER .265.0.94 ClassC-1�
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA•:
Power Apparatus&Large Appliances TION AND.STATE THAT THE ABOVE IS CORRECT AND AGREE TO
Size.&Type.HP,,KW,KVA,.or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
Up to 1 Incl. 2.'50
REGULATING ELECTRICAL.WIRING:
,
I HEREBY CERTIFY THAT AM PROPERLY REGISTERED AND/OR '
Over 1 to 10 Incl: 5.:00 LICENSED AS REQUIRED BY[LOS ANG. O. TY AND STATE F
Over 10 to 50 Incl,
12:.5.0 CALIFORNIA OR THAT'I E L A O ER OF THEA E
Over 50 to 100 Inc.
25100 DESCRIBED RESIDENTI R TY
Over 100 40:00 PERMITEE
SIGNATURE
Services DISTRICT NO.: PR -ESSE Y
0.200:Amp.Under 600 V 12,5.0 S✓ c.�_o J
201.1006 Amp.. Under 600 V 25:00 a
Over l 000,Arnp.'or Over 600 V 50.00
• '�I � V
Temp.Power Pole.&Appurtenances 10.00 C
Sign with One Branch Circuit 10;00 j
Additional Sign Branch.Circuits 2'00 INSPECTION
10:00 INFORMATION - 1 1 4,9 A
Misc.Conduits&Conductors ON REVERSE. x
Other(See Complete Fee Schedule) SIDE u # 0 0 0 o o 2
Z
5 2oo1IL50
14505
4,505
PERT FEE. (Sub-Total) 7.r5C
PLAN CHECKING FEE (One-Fourth Permit Feel O 1.0 3 7$
PERMIT ISSUING FEE $7100 7
TOTAL FEE 14
M
INSPECTION'F .ALE a
date: �, ®) BY Os