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78A689-cE808068 APPLICATION FOR ELECTRIC PERMIT
•-. "'-COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING '/ Y '/
BUILDING AND SAFETY DIVISION ADDRESS '7' 3 jO yON��
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY
FINEAREST APPLICANT TO FILL IN CROSS ST.
NO. EACH FEE
$ $ OWNER �J NK
RECEPT,s�, MAIL
LIGHT J TOTAL FIRST 20 .20 O .ADDRESS
SWITCH OVER 20 .10 ICITY TEL. NO.
y� PLAN CHECK
LIGHTING }TOTAL FIRST 20., _3 .20 6V .APPLICANT
FIXTURES 1 OVER 20 .10 ADDRESS
RANGE_DRYER—WTR.HTR.— CITY TEL. NO.
STA.COOK_DISP.—F.A.U._ CONTRACTOR L-AS
SPACE HTR. ' AIR COND. ADDRESS
CLOTHES WASH.-LDISHWASH._ CITY +u EL. NO.
FAN—OTHER "001UV LICENSE NO. S �� _ CLASS.
MOTORS,TRANSFORMERS RATING
IND. HEATERS, ETC. HP. KW. KVA. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING.
0 - 1 1.00 1
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
1 - 10 3.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO a
10 - 50 5.00 RESIDE IN, THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. O
50 - 100 10.00 'SIGNATURE V
]TEMP.
F PERMITTEEad
100 - 500 15.00 O
DIST.RICbN Z NE P EDB G
SIGN,GAS SIGN AND ONE CIRCUIT 3.00 O WTUBE, OR a MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES• ZSERVICE NOT OVER 600 VOLTS OR200 AMP 2.001.SERVICE OVER 600 VOLTS OR 200 AMP 5.00
TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE
POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
PERMIT FEE (SUB TOTAL) WIRING �. P
FIXTURES
PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED
PERMIT ISSUING FEE 2.00 UTILITY CO.NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEEI.
1.00 FINAL O
TOTAL FEE JOSE H C. ROOHAN
SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
6 -3 2 3c':-' 'AUG 14 2 D 5.0 Q;,4 :1
!E 13ACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
[AS419-CE906 10-60 APPLICATION' FOR ELECTRICAL PERMIT 1
COUNTY OF LOS ANGELES
DEPARMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A.JENSEN.SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
PERMIT FEES OWNER
I T E M NUMBER EACH I %FEE MAlh
OUT L S $ ADDRESS
LIGHTS � REC SW. AO CITY . TEL.NO.
LIGHTING FIXTURES b _jp ,10 4dipq �9p��
ELEC.RANGES CLO.DRYERS E@,ECTRICIANJlCAi3i1L'SOR ^.••n.CITina
WATER. HEATERS ADDRESS 8923 F. Broadway
ELEC.SPAfHTRO. SHWASHERS' - CITY Moray
at
palii'• AT'.7-053GARBAGEO� � STATE
� /[/WABHODKIi1G UNITE .25M L•ICENSfi NO.MOTORSINC. H.P.
DIPTCT Mpl
Z NEr P OC D Y
I/s 28 �1
y$— 2 ,Sp INSPECTION RECORD r
a— 5 1.00 p
5— Is 1.50 u
is— 80 2.50 O
BO— 200 S. O
SIGNS:
NO TRI►N8.
y
NO.LAMPS jZ
SERVICE 0-SOOV 1.00
SERVICE OVER BOOV 8.00
MISC.
WIRING PERMIT 1 . 1.00
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT Bp
TOTAL FEE' S 0
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS,APPLICATION , APPROVALS DATE• INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT ���
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
I HEREBY CERTIFY T.' I AM PROPERLY ST D OR
LICENSED AS REOUIR LOS ANGELE Y A OF FIXTURES
CALIFORNIA OR THAT M TFt,6 LE A R T BOVE
DESCRIBED R NTIA OPERTY. POWER 1 ��r!
SIGNATUR UTILITY CO.NOTIFI
OF PERM! FINAL l % �
IDATION ARTHUR C.VETT
7�
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
Lt 7920 e�{3 5 2 D 9. r
78A889'�M.. APPLICATION FOR ELECTRICAL PERMIT
o
VIM �;hCO3JN-TY OF LOS ANGELES
DEPARTMENT OF C' LINTY ENGINEER ADDRESS
BUILDING ANDS FET.DIVISION .� i w •
LOCALITY a `T
FOR APPLICANT TO FILL IN NEAREST
CROSS ST,
OUTLETS NO. EACH FEE OWNER OR '
FIRM NAME Vt iJ
RECEPT._ $ $ MAIL
LIGHT TOTAL
FI RST 20 25 ADDRESS —4-LY�
SWITCH_ OVER 20 -CITY TEL. NO.
10
PLANCHECK
TOTAL
LIGHTING 1 FIRST 20 .25 APPLICANT
FIXTURES .f0
;
)}
OVER 20 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL. NO.
PERMIT
RANGE DRYER_WTR. HTR. APPLICANT %IDti
STA. COOK DISP. F.A.U. ADDRESS 3Cj Z5'
SPACE HTR. AIR COND. CITY t TEL. N0. -rp
CLOTHES WASH. 01SHWASH. LICENSE OR O
REG. NUMBER / GLASS�,W
FAN OTHER 1.00 / +J7 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
V AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS, TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING.
SIZE & TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
O - 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF }.
CALIFORNIA OR THAI' I AM THE LEGAL OWNER OF THE ABOVE C7
1 - 10 3.00 DESCRA BED RESIDENTIAL PROPERTY. V
PERM
10 - 50 5.00 SIGNATURE r�-�
50 - 100 10.00 LLJ
DISTRICT N,01.�q 16 DD BY
y
100 - 500 15.00
tp
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS D,CT INSPECTOR'S SIGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE
SERVICENOTOVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK
SERVICEOVER600 VOLTS OR200AMP 10.00 ROUGH CONDUIT
TEMP SERVICE,POLE,&APPURTENANCES 5.00 WIRING r �,
TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES 1 _ 77 b
POWER AUTHORIZED r �/
UTILITY CO.. NOTIFIED
FINAL
PERMIT FEE (SUB TOTAL) NOTES: A!'
PLAN CHECK FEE
PERMIT ISSUING FEE 3.00 4s-
TOTAL
TOTAL FEE
PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CK. .O. CASH
7 5 41!jM 1 E .D 6.0 0 A98
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE