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7GA663 DBS SA 11-60 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY ELECTRIC
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO.
ELECTRICIAN R. F Walton
RECEIVED BY READY FOR DATE ISSUED
ADDRESS 5134 N. Aoaoia Ste FIRST INSPECTION
CITY San Gabe TEL. NO. -AT 68583
COUNTY LICENSE NO. 1104 EXPIRES BUILDING
6122 Primrose
PERMIT FEES
NUMBER I EACH FEE LOCALITY Temple City
LIGHT OUTLETS 13 NEAREST
CROSS ST.
RECEPTACLES 26 ,
WALL SWITCHES '� OWNER Meeker
TOTAL OUTLETS 53 Sc $ 2 65 MAIL
ELEC. RANGES 25 ADDRESS
ELEC. HEATERS I 25 CITY TEL. NO.
FIXTURES g
1 HEREBY ACKNOWLEDGE THAT 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 I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
NUMBERHORSEPOWER ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
FEE I OF THE RESIDENTIAL PROP DESCRIBED ABOVE.
NEW MVD. HP OVER INC. EACH
1 1/2 9 LESS $ .2s 25 SIGNATURE OF
1/2 2 .50 PERMITTE
z s 1.00 INSPECTION RECORD
5 1s 1.50
is 50 2.50
so 1 200 s oo
200 500 10.00 ,2Z_ /0 T
Soo 1000 1x.00 Z _ Z
OVER 1000 20.00 5
M. G. SET/FREQ. CHANGER-HP a
WELDERS'AC-KVA 0
GENERATORS-KW
TRANSFORMERS-KVA
TEMP. MOTORS (75%OFORIG.)
MOVED MOTORS (75%OFORIC.)
MISC.
SIGNS
NO. NO.TRANS.
NO. + APPROVALS
NO. LAMPS
FOR EACH PERMIT: DATE INSPECTOR'S NAME
- (,
llov-
WIRING $1.00 00 CONDUIT
FIXTURES $1.00 WIRING
SUPPLEMENTARY gp FIXTURES s 04d I—,
�
CJ 80 POWER ( I
TOTAL FEE $ I UTILITY CO. NOTIFIED '2,6
® FINAL