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76A668 C811 SA 7-111 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY ��������
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO.
ELECTRICIAN ��
3622 111 RECEIVED BY READY FOR DATE 19BUED
ADDRESS FIRST INSPECTION
CITY FL 7-5962 TEL.NO. �J Y
COUNTY LICENSE NO. EXPIRES BUILDING
PERMIT F ES ADORE
FEE LOC ITY
NUMBER EACH
LIGHT OUTLETS 47 HEEST -p
CR S9 By-
WALL
T O
RECEPTACLES
WALL`SWITCHES OWNER
TOTAL OUTLETS a 50 $ MAIL
ELEC. RANGES •85 ADDRESS
ELEC. HEATERS 25 CITY TEL. NO.
FIXTURES S I HEREBY ACKNOWLEDGE THAT i HAVE READ THIS
MISC. ,r� 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 I POSSESS THE ABOVE VALID LOS
14UM13ER HORSEPOWERANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
FEE
NEW MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
1/2 A LE6a S .25 SIGNATURE OF
%2 8 ,50 PERMITTEEr� a --• _
2 5 1.00 INSPECTION RECORD
5 18 1.SO
15 50 2.50
5o 200 5.00
2013 500 10.00 J
son loco 15.00 Z
Z
OVER 1000 .O0 Is
M.G. BET/FREQ. CHANGER-HP 0!
WELDERS:AC=KVA O
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75% OF ORIM-)
MOVED MOTORS (75% OF ORIo.)
MISC.
SIGNS
NO. NO.TRANS.
APPROVALS
No. NO.LAMPS
FOR EACH PERMITI DATE INSPECTOR'S NAME'
WIRING CONDUIT
FIXTURES Gl,pp ollo WIRING
SUPPLEMENTARY ,50. FIXTURES t
POWER / T _ A
TOTAL FEE 9� UTILITY Co.NOTIFIED 3 ii
FINAL
1