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"663�°E-806`e"8' APPLICATION F R ELECTRICIL PERMIT
COUNTY OF LOS ANGELES BUILI)ING AND SAFETY
FOR APPLICANT TO FILL IN ADDRESS
New Residential Bldgs.&Pools EACH NO.. FEE
04 JfO
1 &2-Family,Sq.Ft. $ .025 $ LOCALITY �— ,Oozr O
Multi-family Sq.Ft. .02 — NEAREST
CROSS ST.
Residential Swimming Pools 25.00 OWNER OR
FIRM NAME C' g
Outlets:Rec 9 Light.3 sw. 2, MAIL
First 20 .50 ADDRESS
Total No. 12 Additional .30 CITY Tel,Noss/ _�
PLAN CHECK
APPLICANT
Lighting Fixtures First 20 •50 ADDRESSona
Additil .30
Total.No. CITY Tel.No.
Fixed Appliances Not Over 1 HP PERMIT
Range—Heater—D.W._ -
APPLICANT
Oven—Dryer_W.M. ADDRESS
Top _FAU _W.H._ CITY Tel.No.
Hood_Fan —Other LICENSE OR
Disp._Room Air Cond. 2.50 REG.NUMBER Class.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA-
Power Apparatus&Large Appliances '' TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO
Size&Type HP,KW,KVA,or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
REGULATING ELECTRICAL WIRING.
Up to 1 Incl. 2.50
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
Over 1 to 10 Incl. 5.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF 99
Over 10 to 50 Incl. 12.50 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
25.00 DESCRIBED RESIDENTIAL PROPERTY.
Over 50 to 100 Inc. �yj�
0&
40.00 PERMITEE c // /
Over 100 SIGNATURE . 2 7 c,
Services DISTRICT NO. ED BY
0.200 Amp.Under 600 V 12.50 p
201.1000 Amp. Under 600 V
25.00 (1 p (7.� .
Over 1000 Amp.or Over 600 V 50.00 Z
O
Temp.Power Pole&Appurtenances 10..00 � Q
Sign with One Branch Circuit 10:00 C
'Additional Sign Branch Circuits 2.00 INSPECTION
INFORMATION u
Misc.Conduits&Conductors 10.00 ON REVERSE _
Other(See Complete Fee Schedule) SIDE v
.aIL
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PERMIT FEE (Sub•Total) 2 0 0 2 7 5 0
PLAN CHECKING FEE (One-Fourth Permit Feel O
o o o27,50zj
PERMIT ISSUING FEE $7.00 0 1. 1
1 -79
_79
TOTAL FEE >
INSPECTIO FINALED
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dater 1 7—�l By F ^-- es
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76AS68 01369A 11-E0- APPLICATION FOR PERMIT
DEPARTIVNT Or' BUILDING AND SAFETY ELECTRIC
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP I ZONE PERMIT NO.
ELECTRICIAN
RECEIVED BY READY FOR DATE ISSUED
ADDRESS 4-' '�� /Oyr'�� FIRST INSPECTION
CITYyl
V TEL NO. 6I) �v r
COUNTY LICENSE NO. 9 EXPIRES BUILDING
PERmrr F S ADDRESS
r O
FEE
NUMBER- EACH LOCALITY
LIGHT OUTLETS NEA
CRO!!ST ST. / / _
RECEPTACLESs V
WALL SWITCHES OWNERFIA
TOTAL OUTLETS SC $ MAIL
ELEC. RANGES 85 r 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 3 AND STATE LAWS REGULATING ELECTRICAL WIRING.
MOTORS I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
NUMBER HORSEPOWERANGELES COUNTY LICENSE, OR I AM THE LEGAL OWNER
FEE
NEW MVD. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
I/2&LESS S .25 SIGNATURE OF
1/2 2 .50 PERMITTE
2 S 1.00 INSPECTI00 RECORD
s 1s ' i.so r
1s so 2.50
50 200 5.00 C� Lr f /�`I-� �•-
200 500 10.00
Soo 1000 15.oo a
OVER 1000 20.00 / ~ Z
M. G. SET/FREQ. CHANGER-HP
WELDERS:AC-KVA
GENERATORS-KW
TRANSFORMERS-KVA
TEMP. MOTORS (75%OF ORIG.)
MOVED MOTORS (75%OFORIG.)
MISC.
SIGNS
NO. NO.TRANS. I APPROVALS
NO. NO. LAMPS
FOR EACH PERMIT: DATE INSPECTOR'S.NAME
WIRING $1.00 6 d CONDUIT
FIXTURES 51.00 U WIRING /�/ r.-.• - - +Y�
SUPPLEMENTARY .50 FIXTURES / • v.j 5;
g POWER S
TOTAL FEE S� I o UTILITY CO. NOTIFIED f v
® FINAL & V-.-h r'�