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APPLICATION FOR ELECTRI AL :PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS' tg/ e, S
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A.JENSEN,.SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
1 T E M NO. .EACH FEE
OUTL •,(FIRST 20) S. OWNER
LIGHTS RBCEPT. SW. •20 '�• •1
MAIL r
OUTLET (ADD'L'UNITS) ' ADDRESS �.
LIGHTBl 'RECEPT. SW. '3`� .10 "" . ,0. .
LIGHTING FIXTURES: (FIRST 20) 2O CITY
LIGHTING FIXTURES: (ADDITIONAL) .f0 ELECTRICIAN
r (`
GES CLO:DRYERS WTR.HTRS. 1.00 ADDRESS v '•
ARB.DISP. A.COOK /G _
!K _ CITY TEL.NO.
DISHWASH. AUTO.•WAS R. STATE
SPACE HTRS. STA.APP.(Va X.P.MAX.) .50 Q LICENSE NO.
MOTORS: OVER NOT OVER H . DISTRIC N GR PN 7F777D7E83
O 1 1.00
1 s 1.50 INSPICTION ECORD
8 8 2.001 1 P` .."L, 171 rI i?tt . ,+t-`rls:vf✓ V
8 15 2.50 u s �/✓!�✓) .[ •- �,� / ag
15 SO 5.00
50 100 S.00j
SIGNS: NO.TRANS. - h
NO.LAMPS Z
SERVICE 0-600V-NOT OVER 200A 1.00
SERVICE 0-600V-OVER 200 A. 2.00
SERVICE OVER 600V 5.00
MISC.
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE $�v
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS. KDAT9INSPECTOR'S SIGNATURE
ANDSTATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUITWITH ALL.COUNTY ORDINANCES AND STATE LAWS REGULATINGELECTRICAL WIRING. WIRINGIIHEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/ORLICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURESCALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. POWER
SIGNATURE r UTILITY CO.NOTIFIED
OF.PERMITTEE • ���i•••///
FINAL "
LIDATION ARTHUR C. VEIT
U;l
MO 'CASH SUPERVISING ELECTRICAL ENGINEER
LAW' 12.6 .9 JW. 2 D 10.5 0N co
Des a-w �17.415 GN ;_• 1�PLICATiON FOR PERMIT' _
DEPARTME B G'AND -SAg'�"rY
�r' +COUNTY' OF LOS:ANGELES =ELECTRIC
t.
WM: J: FOX 'CHIEF ENGINEER
t' NAME' r DISTRICT N.
_ GROUP ZONE PERMIT.NO..
D ADDRESS:
W ;CITY 400& .NO. RECEIVED By,
READY FIRSTT l(d3-ECTION=''' DATEISSUE/D%�
J COUNTY ry/_ OF+ �� F
W ^CERT.NO. pr/. '� EXPIRE . : �
" APPLICANT:- VILY OUTLINED-PORTION ONLY - _
DESCRIPTION OF PORK . '.'roe
_ ''ADDRESS �f _
NUMBER.OF.OUTLETS ON CIRCUITS. a LOCALITY'
'LOCATION BY.ROOMS c,
_ - ,'NEAREST •
LIGHT OUTLETS" SW. PLUGS FOfT CROSS ST.`
CIRCUIT " A- 13. -C. D' E F G 1-"
W .'NAME
Z MAIL
Q'. 3 ADDRESS
O CITY TEL.NO.
1 AM THE LEGAL POSSES90R• OF THE•ABOVE-LOS
ANGELES COUNTY CERTIFICAT F QUALIFICATION..
eLECTe1cIwN. _
I AM.Tl11;LlE6AZ.OYYNER OF TH1:PROPERTY DESCRIBED
ABOVX
t� OWNen.
tY
NO. OF.OUTLETS'
_.APPROVALS
TOTAL
1 NO. OIR FIXTURES - . ffi DATE. ' INSPECTOR'S-.NAME- ,
NO. OF MOTORS H.P: ffi CONDU.IT=
'NO'.'OR SIGNS -'TRANS: ffi I WIRING
NO:.OF RANGES ORMEATERS ffi ' FIXTURES J
M19CELLANEOUS ffi !POWER '
PERMIT FEE - :'� _a ffi �' �v UTILITYCO:NOTIF.IED
TOTAL`FE - �•t "FINAL
COUNTY OF LOS ANGELES APPLICATION FOR PERMIT
Department of County Engineer
DIVISION OF BUILDING & SAFETY ELECTRIC °1
WILLIAM J. FOX, County EnBlooee
FOR APPLICANT TO FILL IN DISTR7 NO. 13ROUP I ZONE PERMIT NO.
ELECTRICIAN 'r "o
ADDRESS ECEIVED BY READY FOR DATE IBBUED
FIRST INSPECTION 0/.JOY
CITY TEL.NO.
COUNTY LICENSE NO. EXPIRES BUILDING `
PERMIT FEES ADDRESS
NUMBER EACH FEE LOCALITY
LIGHT OUTLETS NEAREST
RECEPTACLES
CROSS ST.
WALL SWITCHES 3 OWNER
TOTAL OUTLETS Sr. Q MAIL
ELEC. RANGER ry °� 85 ADDRESS
yy (J fg�j
gs CITY ` TEL NOT�`('JL7f[,
FIXTURES
ELEC. HEATER /V 0 g Y
1 HEREBY A66OWLEW THAT 1 HAVE READ THIS
MISC.
APPLICATION AND STATE THAT THE ABOVE IB 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 I POSSESS THE ABOVE VALID LOB
NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
NEw MVD. HP OVER INC. MACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
%a A LES13 S .25 SIGNATURE OF /
%z 2 .50 PERMITTE �.
a B 1.00 INSPECTION RECORD
5 1B 1.s0 _
Ts sD
s0 200 5.00
200L.. .
00, . 500 10.00 J
500 1000 15.00 Z
OVER 1000 213.00-rl� 0
MOVED MOTORS (76% of owim.) Ix
M.G. BET/FRER. CHANSER-HP O
WELDERS:AC-KVA
GENERATORS - KW
TRANSFORMERS - KVA
MIBC.
A.
GNS
NO. NO.TRANS. APPROVALS
NO. NO,LAMPS
FOR EACH PERMIT. DATE INSPECTORPS NAME
WIRING $1.00 ® CONDUIT
OFIXTURES 01.00 WIRING
INUPPLEM ENTARY .50 FIXTURES
170
POWER
TOTAL FEE 8 UTILITY CO.NOTIFIED �. ''G f"
FINAL 7'�j
76AS63 DBB#3A Cdb 12-53 �� 1
78A863•CE808 0.69 �� �!�L�
APPLICATION FOR/ ELECTRIQ'AL PERMIT
COUNTY OF LOS ANGELES
DEeARTMENT OF COUNTY ENGINEER BUILDING `"°'
w BUILDING AND SAFETY DIVISION ADDRESS V
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALI (,
FOR APPLICANT TO FILL IN NEARES
CROSS ST.
NO. EACH FEE
$ $ OWNER s
RECEIPT. MAIL
ADDRESS
LIGHT TOTAL FIRST 20 .20
SWITCH OVER 20 10 CIT LC TEL,
PLAN CH K
LIGHTING TOTAL FIRST 20 ,20 APPLICANT
FIXTURES )-I OVER 20 ,10 ADDRESS
RANGE_DRYER_WTR. HTR. CITY TEL.NO.
STA. COOK_DISP._F.A.U. CONT
SPACE HTR. AIR COND. ADDRESS
CLOTHES WASH._DISHWASH. CI TEL.NO
FAN_OTHER 1.00 LICENSE N C
MOTORS,TRANSFORMERS RATING 1 HEREBY ACKNOWLEDGE THAT 1HAVE READ THIS APPLICATION
IND. HEATERS, ETC. HP. KW. KVA. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ALL
WIRING.
0 — 1 1'00 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
1 — 10 3.00 CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF, AND INTEND TO S
RESIDE IN. THE ABOVE DE RIB RESIDENTIAL PROPERTY.
10 - 50 5.00
SIGNATURE C
50 - 100 10A0 OF PERMITTE
100 — 500 15.00 DISTRICT NO. GROUP ZO P C SED BY
t l
SIGNGAS SIGN AND ONE CIRCUIT 3.00 co
TUBE, OR
MARQUEE �A"DDDDIITIIONAL CIRCUITS 1.00 NOTES:
NOT 62 w VOLTS OR 200 AMP 2.00
SERVICE OVER 600 VOLTS OR 200 AMP 5.00
TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP. POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
WIRING
PERMIT FEE (SUB TOTAL) FIXTURES
POWER AUTHORIZED
PLAN CHECK FEE (50% PERMIT FEE)
PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL
TOTAL FEE oJOSEPH C. ROOHAN
SUPERVISING ELECTR ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION cK. M.O. CASH
6 7 3 15R SEP 14 2 D7.o o� In
SEE BACK OF APPLICATION FOR COMPLETF FEE SCHEOULF