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COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department of Engineer ELECTRIC i
DIVISION OF BUILDING & SAFETY
WILLIAM J. FOX, County EngIneer
FOR AANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO.
„T
`7 o 370ELECTRICIAN �
EIVED BY READY FOR PATE ISSUED
ADDRESSFIRST INSPECTION
CITY
COUNTY LICENSE NO. EXPIRES BUILDING � r
PERMIT FEES ADORE_
NUMBER EACH FEE LOCALITY "
LIGHT OUTLETS NEAREST
RECEPTACLES CROSS ST.
WALL SWITCHES OWNER
TOTAL OUTLETS 5c M 0 MAIL �L7
ELEC. RANGES Z5 ADDRESS
ELEC. HEATERS 25 CITY _ ir'1sjTEL.. NO.
FIXTURES 5 <v 1 HEREBY ACKNOWLEDGE HAT 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 I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB
NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
EACH OF THE REBIDEN L P P-ETY DESCRIBED ABOVE.
NEw Mw. HP ovER INC. ,� � t)ff�l13
%2 S LESS 16 .25 SIGNATURE OF ,�f"f�O � ��• ,
%s 2 .50 PERMITTED {':• `�
2 s 1.00 INSPECTION RECORD
5 15 1.50 IF/
15 50 2.50 92 AJ AJQ 03&Jr- " •Al A?P rL4 e.11i1
50 200 5.00 O iQC. iAI(?
200 500 10.00
500 1000 15.00 G Z
OVER 1 OOO 20.00
M.G. BET/FRED. CHANGER-HPd.�wD .,�@ �•-// !/�+�-� "-
WELDERS?AC-KVA 13
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75% or aRle.)
MOVED MOTORS (75% of GRIM.)
MISC.
SIGNS
NO. NO.TRANS.
APPROVALS
NO. NO.LAMPS
FOR EACH PERMIT? DATE INSPE OR'S NAME
WIRING $1.00 `� CONDUIT / i
FIXTURES 81.00
WIRING A vdl
SUPPLEMENTARY .BO FIXTURES
v POWER
TOTAL FEE B UTILITY CO.NOTIFIED s
FINAL
75AS63 DBS#5A 2-53