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,"621-COM APPLICATION FOR ELECTRICAL PERMIT,
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A.LAM SIE,COUNTY ENommEn
WILLIAM A.JENSEN, SUP'TOF BUILDING LOCALITY A-100 001
FOR APPLICANT TO FILL IN NEAREST
PERMIT FEES CROSS ST
ITEM NUMBER EACH FEE, OWNS
.MAIL
OUT -? $.10 ADDRE
LIGHT- RECEPT. 6W. +^t.+ f {
LIGHTING FIXTURES !' .10 C N
ELEC.RANGES CLO.DRYERS ELECTR'CI
WATER HEATERS .00 ADDRESS
ELEC.SPACE HTRS. DISHWASHERS CITY• TEL.NO.
GARBAGE DISPOSERS AUTO.. STATE
WASHERS STA.COOKING UNITS .20 LICENSE NO.
MOTORS: ovER INC. H.P. DISTRICT O. I GROUP Z NE I PRPCESSED BY
0.__.. V, .20
2 .00 INSPECTION RECORD
2 — 0 1.00
B — Is 1.00 0
Is — 002.00 ; U
/>c
so — 200 5.000
SIGNS- NO TRANS. -
.NO.LAMPS
SERVICE 0.600V 1.00 r
SERVICE OVER GOOV 0.00
MISC.
WIRING PERMIT 1.00 /
FIXTURE PERMIT 1.00 / n-7)
SUPPLEMENTARY PERMIT .00
TOTAL FEE
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ASOVB IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATS LAWS REGULATING CONDUIT
ELECTRICAL WRING. WIRING
�. I HERESY CERTIFY THAT I AM PROPERLY REGISTERED AND,/OR - ,
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIX'T'URES
CALIFORNIA OR T T AM THE LE OWNIiS F THE ABOVE
DESCRIBED REB PROPERTY. POWER
SIGNATURE UTILITY CO.NOTIFIED . / 4
OF PERM I
FINAL
VALIDATPhL, ARTHUR C.VEIT.
CK Mo f CASH SUPERVISING ELECTRICAL ENGINEER
! 2018 f" 28 2 D 2.80 ;°
76AS63 DSS SA 11-50 r APPLICATION FOR PERM
DEPARTMENT OF BUILDING AND SAFETY ��
COUNTY OF LOS ANGELES
WILLIAM J. FOX..CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUPZONE PERMIT NO.
ELECTRICIAN I F,573
�..s RECEIVED BY READY FOR DATE ISSUED
ADDRESS 1 / Sri yrs�sr y FIRST INSPECTION
CITY
COUN LICENSE NO. &q EXPIRES BUILDING
PERMIT FiEd
ADDRESS
NUMBER EACH FEE LOCALITY U�,.,,/��^.�
LIGHT OUTLETS NEAREST
RECEPTACLES
WALL SWITCHES I, OWNER JV
TOTAL OUTLETS AR, Sc $ 0
• MAIL
ELEC. RANGES 25 ADDRESS
ELEC. HEATERS 25 CITY TEL. NO.
FIXTURES S I 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 I POSSESS THE ABOVE VALID LOS
NuMeER HORSEPOWERANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER
FEE
NEW MVD. HP OVER INC. EACHOF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
IA 6 LESS $ .2S SIGNATURE OF
1/2 2 .50 PERMITTE v/
2 s 1.00 INSPECTION RECORD
5 15 1.50
15 50 2.50 /(
SO 200 5.00 ✓`/J ' v J�� �f. V4 v-
200 500 10.00 .1
500 1000 15.00
OVER 1000 20.00
M. G. SET/FREQ. CHANGER-HP a
WELDERS:AC-KVA j
GENERATORS-KW
TRANSFORMERS-KVA
TEMP. MOTORS (75%OFORIG.)
MOVED MOTORS (75%OFORIG.)
MISC.
SIGNS
No. NO.TRANS. I I APPROVALS
NO. NO. LAMPS DAPYE INSPECTOR'S NAME
FOR EACH PERMIT:
CONDUIT
WIRING $1.001 loo WIRING —� to�� -✓�
FIXTURES $1.00 n U
SUPPLEMENTARY .50 FIXTURES 7^fM 7
rj POWER
TOTAL FEE $ �e/ UTILITY CO. NOTIFIED
® / FINAL V
147
76ABBS-CES061/70 APPLICATION FOR ELE IAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
ADDRESS
BUILDING AND SAFETY DIVISION
7
JOHN A. LAMBIE. COUNTY ENGINEER LOCALITY �PLE CC*" VIA-LIF
COLEMAN W. JENKINS. SUPERINTENDENT OF BUILDING /f L,
FOR APPLICANT TO FILL IN CROSSNEARENEAREST
�3�c.l�l,�)� WC-2 i�L2.c�SiR
OUTLETS N0. EACH FEE _
S $ OWNER d� Lz! GIGS 0
RECEPT._ MAIL �S'� I� �I L��►� A`y
7
FIRST 20 .20 ADDRESS
LIGHT TOTAL CITY"tT) pLr e LT'Y TEL. NO. 4f4 V-30�
SWITCH OVER 20 f0 PLAN CHECK
LIGHTING TOTAL FIRST 20 20 APPLICANT
FIXTURES
OVER 20 •10 ADDRESS
APPLIANCES CITY TEL. N0.
PERMIT
RANGE DRYER_WTR. HTR. APPLICANT
STA. COOK DISP. F.A.U. ADDRESS
SPACE HTR. AIR COND. CITY TEL. NO.
CLOTHES WASH. DISHWASH. LICENSE NO. CLASS.
FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 13 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
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
O — 1 1.00 LICENSED-ALREOU1RED BY LOS NGELES'COUNTY AND STATE OF
CALIFO IA ORtAT01M�THEEGAL'C WNER OF, AND INTEND TO
1 — 10 3.00 RESIDE RESIDENTIAL PROPERTY.
SIGNATU
d
10 — 50 3.00 OF PERM[ V
50 — 100 1oAo
DISTRICT NO. CLASS GRO ON 33 ED BY 0
too — Soo 13.00 �D 9 — 0
SIGN, GAS SIGN AND ONE CIRCUIT 3.00 NOTES: W
O.
TUBE, OR ' Z
MARQUEE ADDITIONAL CIRCUITS 1.00
SERVI CENOT OVER 600 VOLTS OR 200 AMP 2.00
APPROVALS DATE INSPECTOR'S SIGNATURE
S ERVI CE OVER 600 VOLTS OR 200 AM P 3.00
TEMP.POWER POLE
TEMP SERVICE,POLE,&APPURTENANCES 3.00
UNDERSLAB WORK
TEMP LIGHT OR RECEPT. SYSTEM 3.00
ROUGH CONDIUT
WIRING
PERMIT FEE (SUB TOTAL) FIXTURES
PLAN CHECK FEE (50% PERMIT FEE) POWER AUTHORIZED
UTILITY CO. NOTIFIED
PERMIT ISSUING FEE 2.00 112 0
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL
JOSEPH C. ROOHAN
TOTAL FEE , 00 SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CA H
I Af' 8 6 2L JuN15 2 D 4.00-
C.
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE