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°" °E°°°'°°' APPLICATION FOR ELECTRIC PERMIT 1
COUNTY OF L S ANGELES
DEPARTMENT OF C�UNTY ENGINEER BUILDING
BUILDING AND 8' FETY DIVISION ADDRESS 6
JOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A.JENSEN.SUPT OF BUILDING LOCALITY l ` `
FOR APPLICANT TO.FILL IN kEARESI
PERMIT FEES CROSS S . °—
ITEM NUMBER EACH FEE OWNER
OUTLETS: E s MAIL
ADDRESS
LIGHTS RECEPT. SW. .10 D
LIGHTING FIXTURES 10 CITY TE O.
ELEC.RANGES CLO.DRYERS ELECTRICIAN'
WATER HEATERS .50 ADDRESS d?sd
ELEC.SPACE HTRS. DISHWASHERS CITY / L I
TEL.NO 7`O �
GARBAGE DISPOSERS AUTO.- STATE
WASHERS STA.COOKING UNITS .25 LICENSE NO.
MOTORS: OVER INC. H.P. DISTRICT NO. I GROUP I ZONE PFPCESSED BY
J
0— 1/a 25
S, �2 0
I/g.— 2 •50 INSPECTION RECORD
2— 5 1.00
f
a— 15 1.50
is— 50 2.50 '
50-200 8.00
SIGNS: NO.TRANS.'
NO.LAMPS
SERVICE 0-600V 1.00
SERVICE OVER SOOV 5.00
$ MISC.
WIRING PERMIT 1.00 ! 06
FIXTURE PERMIT 1.00 0
SUPPLEMENTARY PERMIT .50
TOTAL FEE is
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
WITH ALL .COUNTYORDINANCES AND STATE LAWS REGULATING CONDUIT
ELECTRICAL WIRING. I/]
WIRING
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES C!• a O Iel� J��`-'F/ �J '
CALIFORNIA OR THAT I AM TH6 L NER OR THE. ABOVE t
DESCRIBED RESIDENT PERTY POWER
SIGNATURE UTILITYCO.NOTIFIED
OF PERMITTEEFINA ' t�P f is f h
�P
eVAVDATION ARTHURSUPERVISING
N VETT, -
cK/J MO CASH SUPERVISING ELECTRICAL ENGINEER
76A663CE-806(11 /78) APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN ' ADDRESS 7�a Rowl,• I D
New Residential Bldgs.&Pools EACH NO. FEE JOB
1 &2-Family,Sq.Ft, $ . .025 — $ LOCALITY7.1"1 L t7
Multi-family Sq. Ft. .02 — NEAREST
CROSS ST.,
Residential Swimming Pools 25.00 OWNER OR
FIRMNAME W.
MIKE
6126-614
Outlets:RecjA_Light-10—Sw. MAIL
First 20 •50 10 CD ADDRESS
Total No.20 Additional .30 CITY - Tel.No v
PL
PAN CHECK
A
Lighting Fixtures First 20 50 ADDRESS
Additional .30.
Total No. CITY Tel.No.
Fixed Appliances Not Over 1 HP PERMIT �c'nn��'' nn �yr� +�
APPLICANT (2Vf F— 600 AGAZ
Range_Heater_D.W.— `
Oven_Dryer—W.M. ADDRESS 1 Vf po
Top _FAU W.H._ CITY MI..Lf_tof Tel.Na. Z0 _
Hood—Fan I Other_ �± n
Disp.—Room Air Cond. REGLICE.NUMBER '+�V
2.50 SE OR �J�•G+�• .Class
�F HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA•
Power Apparatus&Large Appliances TfP1N .AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO
Size&T COMPLY WITH ALL COUNTY ORDINANCES-AND STATE LAWS 3`
Type HP,KW,KVA,or KVAR 2 50 REGULATING ELECTRICAL WIRING. O
Up to 1 Incl. 1 HEREBY CE IFY THAT 1 AM PROPERLY REGISTERED AND/OR V
Over 1 to 10 Incl. 5.00 LICENSED AS R I ED BY LOS ANGELES COUNTY AND STATE OF 1119
Over 10 to 50 Incl. 12.50 CALIFORNIA THAT I AM THE GAL
Over 50 to 100 Inc. WIVER OF THE ABOVE
25.00 DESCRIBED S TIALpROPERTY p..
�
Over 100 40.00 PERMITEE
SIGNATUR f>9
Services i� DISTRICT NO. P E E Y
0-200 Amp.Under 600 V 12.50 1
201-1000 Amp. Under 600 V 25.00 (J
Over 1000 Amp.or Over 600 V 50.00 Z
O
Temp.Power Pole&Appurtenances 10.00
Sign with One Branch Circuit 10.00
Additional Sign Branch Circuits 2,00 INSPECTION >
INFORMATION
Misc.Conduits&Conductors 10.00 ON REVERSE
Other ISee Complete Fee Schedule! SIDE u
g � o v o 0 o
d
PERMIT FEE ISub-Totals o o o
PLAN CHECKING FEE (One-Fourth Permit Feel O
PERMIT ISSUING FEE $7.00 D
TOTAL FEE >
INSPECTION FINALED q W
date: /���'�/ By d ®s