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76A56.A-CEBO6 x1/70 APPLICATION F R ELECTRICAL I RMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER FN -
E
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BUILDING AND SAFETY DIVISION S SSI I
'COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING TY
T
FOR APPLICANT TO FILL IN ST.
OUTLETS NO. EACH FEE
0� OWNER
RECEPTIa S S MAIL
/ FIRST 20 P,D 25 �() ADDRESS
LIGHT TOTAL
OVER 20 ! 10 J CITY TEL. N0.
SWITCH PLAN CHECK
FIRST 20 25 00 APPLICANT
LIGHTING TOT L
OVER 20 ADDRESS
FIXTURES .10
PLIANCES CITY TEL. N0.
PERMIT (/1-�� /J _
RANGE VVV DRYER_WT . HTR. APPLICANT �(,t2J ' l-Cl
STA. COOK DISP.V F.A.U. ADDRESS p��'p- /
SPACE HTR. F(CO ID. CITY �U TEL. NO.V(jO 1U W G
CLOT,HES/WW_�-_KSLH. ZDISHWASH. LICENSE NO.,*58 5 8 CLASS. C��
FAN ✓ OTHER 1.00 1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
VVV AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND, HEATERS, ETC. HP. KW.KVA. ELECTRICAL WIRING.
SI
ZE & TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF, AND INTEND TO }
1 = 10 9.00 RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. C6
SIGNATURE U
10 - 50 5.00 OF PERMITTEE
50 - 100 10.00 0
DISTRICTNO. CLASS ZONE P OC Y V
100 - 500 15.00 '--O
CL
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOTES: yLj° h
TUBE, OR Aaepc
MARQUEE ADDITIONAL CIRCUITS 1.00 ejL&&46jv
SERVICENOTOVER 600 VOLTS OR 200AMP 3.00 v�
APPROVALS DATE INSPECTOR'S SIGNATURE
SERVICE OVER 600 VOLTS OR 200 AMP 10.00
TEMP.POWER POLE
TEMP SERVICE,POLE,&APPURTENANCES 5.00
TEMP LIGHT OR RECEPT. SYSTEM 3.00 UNDERSLAB WORK
ROUGH CONDIUT qq
WIRING 9 � /� �l���f
FIXTUR"
POWER 171ED
UTILITY CO.
PERMIT FEE (SUB TOTAL). G; CO. N
✓✓ NOTIFIED
PLAN CHECK FEE
FINAL
PERMIT ISSUING FEE 3.00 U0 JOSEPH C. ROOHAN
TOTAL FEE Q, Q SUPERVISING ELECTRICAL ENGINEER.
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION %M.O. CASH
.1-001
r� 2 ^ nN AUG1$. 2 D 28.90-
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE