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D5A 12+54 APPLICATION FOR ELECTRIC PERMIT 9
CES-SA e •
DMSION OF BUMDING AND SAFETY i
Deptutlnent of County Engineer '
County of 1.08 Angeles ,�' � BUILDING.
WM.J.FOX, COUNTY ENGENEER ADDRESS
:CASSATT D.GRIFFIN,SUPT OF BUILDING -
FOR APPLICANT TO FILL IN LOCALITY
PERMIT FEESNEAREST
... CROSS ST. .,�ar:!
• FEE.NUMBER EACH ,
LIGHT OUTLETS 'OWNER
RECEPTACLES M41L
ADDRESS
'WALL SWITCHES
TOTAL OUTLETS CITY TEL. NO..
ELEC. RANGES a5 ELECTRICIAN
ELEC.HEATERS 25 ADDRESSi�`f.. ST
KW EA CITY _5* -A¢ e/7!TEL. NO - '� r .
FIXTURES .. 5 LICENSE NO...
NUMBER.OF LIGHT CIRCUITS
NUMBER OF RECEPTACLE CIRCUITS
DISTRICT N.O. I GROUP N�READY FOR INSPECTION
` 5 �•' '¢)�'
MOTORS
NUMBER HORSEPOWER FEE INSPECTION RECORD
NEW MVD. HP OVER INC. EACH
Y2&LEGS '$ .25
_ lft 2 .50
2 5 1.00 .,JAB c t.Y -�! •���i 9 t! _y
5 15 - 1.50 /^.. . ,� _ !1�� L i A"°� -c^/• %, j , J_w . ^� s�
i5 50 2.50. rs A F f�/'w 67• RC- .vim F1•� � ♦.
50 200 5.00' 47-TTf
MISC. +j- fiY/' '.i?{` >/ r••fs`s` r
NO. SIGNS NO.TRANS.
NO.SIGNS NO.LAMPS ` d=eV L— .i.
FOR EACH PERMIT: '6 L. -
WIRING $1.00 p 91
FIXTURES $1.00
V
SUPPLEMENTARY - gp
APPROVALS
TOTAL FEE $ DATE INSPECTOR'S SIGNATURE
I HEREBY ACKNOWLEDGE THAT '1 HAVE READ THIS APPLICATION CONDUIT
AND STATE THAT.THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES' AND STATE LAWS REGULATING WIRING
ELECTRICAL WIRING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANWOR FIXTURES
LICENSED AS REQUIRED BY'LOS ANGELES COUNTY AND STATE OF
CALIFORNIA.OR THAT i AIA THE LEGAL OWNER :OF THE .ABOVE POWER.
DESCRIBED RESIDENTIAL P •PER
_
SIGNATURE UTILITY CO:NOTIFIED'
OF PERMITTEE ✓ FINAL
J.FOX,C LINTY E 61NEER VALT P$ A-leANWk 6- .'2 1 .25 �
BY �P_! r•:�i�x ,� ��cac�
VVOFKEW
DECLARff
have a B111p I of m m -' o '°'°' APPLICATION FOR ELECTRICAL PERMIT
I haaby fttTlm ttnd I hers . aertMiaala d aaaent m .df Ilaua
a (� Ct wlbn h simanoo or a na Mmt' • COUNTY OF LOS ANGELES r BUILDING AND SAFETYoopv v
P ww No. CDMPNb FOR APRJCANT 70!sl N im ,y `J(J
Q' CwdW spy b heeby funddmed. Now Radderdid Bldpa A Pdob EAM NO. FEE77
13Q~ aopy Is Sod wMh the call* tt IdIm k ipum 1 a 2-Fan*.84•FL ' L)CN1iY 7yr/t•:' __ 7 70
dab►Sq.prbfornL Md*4jn IL
— •' .. A•f.'1 -''
Dots APP�nt I Raalderdld 8olnlflknp Poole OMM OR "Jr.•LCERTFICKrE r1 ff,/�•(r '
` COM MAL
ENOff ON W3URAN CE EXEMPTION FROM VVOFKEWOndlets RsO�_Lljtt 8mm. ACCfaaee ;j/Ar ,/•I[ �/�� f• •• •}.
(This asdbfn'need not be contpl - M the wdfk lowland by the' :S:( f: C lire!20
pend!Is far am handfed ddkm($100)or bane 'fold No. � AdditionalCRY 7eL Na
'� /t;!.1/ /r• • G.
HEMC
1 ow*dmt h the pwb..w d tlo work for whbh this psrml �
be�efddb the wV On ark Pelson so as b t Lbhft FM Flat 20 ADDRE884110- 't
APP�d „t,- Tald N06 AdditionalCITY .•�.TTL No.
NOTICE TO APPLICANT: M, Mar mil' 96 CsrlllodD d' Find AppMaoes Not Over 1 HP pgp„sr i
Efam96oyshmmtd bsooms antlsot lothe Mbrlara'rr, ip mfnadlon I Row— HeateDAD _ APPL1GNtr
n, ou
p uAdao of the Labor Cods,you nalat forthwill ocaply vttllh a mh' Oran _ Dryer_ WAL_ , ADDREW
prtialfbfe or this pwmlt doll be f)semed feuded. . 'lbp _ FAU WH_
• r ICENSFn.CCNiAACiOR11 DECLARATION 'i Hood — R m _ OIhw CITY 'ibl.Na
(,hemby d&.. OM 1 on Icareed fader proyblons of Ceptor Q. Dbp• _ Roan Air Can& _ LKSW OR Clea f
(awrmwnoleM with SeoM0n.7000)of DNldon 3 of the Budress andFEZ
0161FSC�N0�
Prdsalore Cods,and or Or m m 1 Is le fd fortis and ego al Fpm APPS a Largs APPS �
abs a Typs HP.KW,KVA,or.KY RR t •
Lberps Number U0.Cbaa Up to 1 ind. � FINIAL
Over 1 to 10 111101. QAiE
Co111reoEar Dols
over 10 to 60 tad.
❑ I am affempt under7lac Over 60 tb 100 Inti. By
B,aPJM for this lesson Ovar 1b0
Dew: Servbea,Swbd.,MCC a Parwlboards .
0-200 Ante.Under 60o V
Smf s 201-1000 Amp.Under 300 V ,, t gyy
1
.❑ Over 1000mp.AorOvar 800 V �t . ,F
Enantpllon for Rap.MdnL EIwL ' •1 WOt , t
i •,
8LE FAMILY Tirw Plummer Fbb a Apparfenanoas P, i°�1°I44,a,pf
HOME ONNER-BULDER DECLARATION sen with Oro Branch ChouM 1�1f�'lei,��;h R R�,•
I husby IMrm that I am afalafnpt from this Wlbocw Lbsrnan Law
for the idkNft reason(8eotlon 7091.6,Wiliness old Prdofd Addlllorol 8bn aselCiroults
Cods):
4 do ty.w
corer d the propertn the work end the atruolurg 1611M Carndtfie a Carndudore•
as
le not Inbndad or all m Tar sale(Seodm 70446 Budnean ( Fee )—
en ►
pd Prdesebrn Cods). t
CONBTRIXTION LENDWO AGENCY
..P I famby afMnn that there In a corlalnmolbn bfndtrp agenev for t7 ,
perfM i ance'd the wont'for which ihle permit b blamed(Sea 306 . PERMIT FEE (Sub-ToW) 7 .
qv.Q). ` PLAN CHECIONG FEE
Lenders None
PERMIT MIMING FEE
Landa'b Address
I OR*Flet I have read tits app&Wm end wits that to abwan TCDD FEE
Idantndbn is nn an I apnea b comply with d County ord.
led 8tde boa faonratlp Ebatrbd eby wkft and herau0w kb
rapraserttalras of Fhb Ifo grnbr upon the above-men" .
for
�� mow•
Jt an REVERSE FOR EXR.ANWORY IANOUAOE
Sldfekm Of Pwmbn Dais .m ,