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76A"3 DBB SA 11 BD APPLICATION FOR PERMIT
� DEPARTMENT OF BUILDING AND SAFETY ELECTRIC
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COUNTY OF LOS ANGELES
WILLIAM J FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO GROUP I ZONE PERMIT NO
ELECTRICIAN cat AEJ."7-JPJc SMbt=
ADDRESS RECEIVED BY RIRINSPECTION
ADY FOR DATE IB/B =
CITY JEA MA Mor TEL NO - t4
COUNTY LICENSE NO D EXPIRES BUILDING �r
PERMIT FEES ADDRESS ,.S /.'f . ®AK .4 war,
NUMBER EACH FEE LOCALITY
AMMA.B /TY
LIGHT OUTLETS NEAREST
RECEPTACLES CROSS ST � _Rk M N YE
WALL SWITCHES OWNER W, Q&n a jrc r e
TOTAL OUTLETS Sc $ AAIL
ELEC RANGES 25 ADDRESS G tAmeA A /TVs-
ELEC HEATERS 25 S CITY Age.4D 1 A TEL NO
FIXTURES B 1 HEREBY ACKNOWLEDGE THAT 1 f1AVE READ THIS
MIBC 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 LOB
NUMBER HORSEPOWER ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
NEW MVD HP OVER INC EACH
FEE OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE
V2 s LESS B 25 SIGNATURE OR I
I/2 2 50 PERMITTE
2 5 1 00 INSPECTION RECORD
5 is 1 SO
is So 250
50 200 Boa i C'Qoeru0 /�G•e STr-�. o u rL LPA'
200 Boo 1000 ,g x•�s o w4ff e ,r,r G.o a J
Soo 1000 1500 z
OVER 1000 2000 0
M G BET/FREQ CHANGER HP
WELDERS AC KVA O
GENERATORS - KW
TRANSFORMERS KVA
TEMP MOTORS (75% DF CRIB)
MOVEP MOTORS (75% OF DRIB)
MIBC
SIGNS
NO NO TRANS
APPROVALS
No NO LAMPS
FOR EACH PERMIT DATE INSPECTOR S NAME �
WIRING 61 Co OQ CONDUIT
FIXTURES $1 pp WIRING
SUPPLEMENTARY 5p FIXTURES L +
POWER
TOTAL FEE S 0'1 UTILITYCO NOTIFIED O
FINAL b _r4,
TEMPLE CIT"if
76A66C CE#606 5-61
APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARMENT OF COUNTY ENGINEER BUILDING dl ?y
BUILDING AND SAFETY DIVISION ADDRESS tJ
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY
NEAREST i
FOR APPLICANT TO FILL IN cRoss sT. in
/PERMIT FEES OWNER r �[J
I T E M NUMBER EACH I FEE MAIL c
OUTLETS: S S ADDRESS
LIGHTS RECEPT. SW. .10r� .► .� 7/ (1 2
CITY Z� TEL. NO.
LIGHTING FIXTURES10
/
ELEC. RANGES CLO. DRYERS ELECTRICIAN K. e'j '
WATER HEATERS .50 ADDRESS �.' GYM, :•� /�V
ELEC.SPACE HTRS. DISHWASHERS
CITY TEL NOf��y /
. .
GARBAGE DISPQ,2,l;R,�,,,!F AUTO.- _ STATE
WASHERS�1 STA.COOKING UNITS ,25 ! LICENSE NO. 02 U,._�
MOTORS: OVER INC. H.P. DISTaRICT _O. GROUP ZONE P ESSED B
0— 1/2 .25
1/2— 2 .50 INSPECTION RECORD
2— 5 1.00 O
5— 15 1.50 V
15— 50 2.50 99
O
50— 200 5.00 U
W
NO TRANS. - 0.
SIGNS:
NO.LAMPS Z
SERVICE 0.600V 1.00
SERVICE OVER 600V 5.00c-
M Isc.
WIRING PERMIT 1.00 I •1 ' }
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT .50 '
TOTAL FEE S
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
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER F THE ABOVE
DESCRIBED RESIDENTIA PROPERTY.; POWER
SIGNATURE 1 /
OF PERMITTEE liLI /. UTILITY CO.NOTIFIED ''J
FINAL
ULIDATION ARTHUR C. VEIT
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
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