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7EA66 DBB SA 3-SO APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES ELECTRIC i
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE I PERMIT NO.
ELECTRICIAN
RECEIVED BY READY FOR DATE ISSUED
ADDRE FIRST INSPECTION _
CITU )-ii TELN. r t-/ , q d-♦5 `1
COUNTY LICENSE NO. EXPIRES V ` BUILOI B IfL IS= / ��'�✓ O
PERMIT FEES
NUMBER EACH FEE LOCALITY ,A -V/ !✓�
LIGHT OUTLETS NEAREST
CROSS ST. J�C.U.hC
RECEPTACLES L 1 p
WALL SWITCHES OWNER
TOTAL Ol1TLETH Sc >0 MAIL
ELEC. RANGES 2g ADDRESS
ELEC. HEATERS 25 CITY \ I-R1� EL. NO.
FIXTURES j 5
1 HEREBY ACKN LEDGE TNAT 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 1 CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
NUMBER HORSEPOWER ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
FEE
New MVD. HP ave. lac. cwcH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
I/ s LESS $ .25 SIGNATUREV.
V2 2 50 PERMITb'E
2 5 1.00 INSPECTION RECORD
5 15 1.50
15 SO 2.50
50 200 5.00
200 500 10.00 ..IQ
Sao 1000 15.00 Z
OVER 1000 20.00 p
M.G. BET/FRED. CHANGER-HP B:
WELDERS:AC-KVA D
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75% aF aalB.)
MOVED MOTORS (75% of DRIG.)
misc.
SIGNS
NO. NO.TRANS.
APPROV S
Np. NO. LAMPS
FOR EACH PERMIT: DATE INBPECTORIB NAME
WIRING 81.130 CONDUIT /
FIXTURES $1.00 A WIRING
SUPPLEMENTARY ,50 FIXTURES
(.: �... POWER
TOTAL FEE B -, .�`a !.� UTILITY CO.NOTIFIED
FINAL