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76AGS3 DSS 5A 3-5 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.
7
gJ l� , /
ELECTRICIAN RECEIVED BY READY FOR DATE ISSUED
ADDRESS t . FIRST INSPECTION
CITY V �TEI.NO �~ '
COUNTY LICL49E NO. 3-:A/0 EXPIRES BUILDING
ADDRESS d
PERMIT F93BI
FEE
NUMBER EACH LOCALITY .L./ ^.
LIGHT OUTLETS NEAREST
CROSS ST.
RECEPTACLES A -
WALL SWITCHES 13WNER I./.�_+ !/_�.�i II+' 2 F4 �SA.•r+A tf�?a�
TOTAL OUTLETS 5o 19 MAIL v
ELEC. RANGES 85 ADDRESS
ELEC. HEATERS 25 CITY TEL. NO.
FIXTURES 5 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
MISC. APPLICATION AND STATE THAT THE ABOVE IB CORRECT
NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING.
MOTORS 1 CERTIFY THAT I POSSESS THE ABOVE VALID LOS
NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
NEW MVC. HP OVER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
%s & LESS S .25 1 SIGNATURE OF /
1/2 2 .50 PERMITTEES
2 5 1.00 INSPECT OPT RECORD
5 15 1.50
15 50 2.50
50 20o 5.00
200 SOo 10.00 J
Boo 1000 1s.00 Z
OVER 1000 20.00 Q
M.G. BET/FREQ. CHANGER-HP
WELDERS.AC-KVA O
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75% or CRIB-)
MOVED MOTORS (75% of oRIG.) -
M ISC.
SIGNS
NO. NO.TRANS.
APPROVALS
NO. NO.LAMPS
FOR EACH PERMIT. DATE INBPECTORvB NAME
WIRING $1.00 CONDUIT
FIXTURES $1.00 WIRING
SUPPLEMENTARY .50 FIXTURES
POWER
TOTAL FEE UTILITY CO.NOTIFIED I
FINAL
76A663-CE$06 8,68 APPL1-CATION FOR ELECTRIC PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY BUILDING AND SAFETY DIV 8101�ER
=813
JOHN A. LAMBIE, COUNTY ENGINEERWILLIAM A.JENSEN,SUPT OF BUILDING ba c lift Cj
NEAREST
FOR APPLICANT TO FILL IN CROSS ST. a ;7 V$
RECEPT. I TOTAL NO. EACH FEE
OUTLETS FIRST 20 ' S 2O S OWNER r'r cF
LIGHT MAIL
Q 3 C> ADD'L A ADDRESS .Z 1 Fr
SWITCH. O - 3C>
OVER 20 V .10 tA�IDDRESS
LO '
LIGHTING I TOTAL F1RST 20 8 .20 shy TEL.NO. y7' 734
FIXTURES 1} ADD'L 1O CTRICIAN
0V9R 20
RANGES CLO.DRYERS YIITR.HTRS. 1.00 HI
GARB.DISP. BTA.COOK c
CITY J TEL.NO.
DISHWASH. AUTO.-WASH. STATE
SPACE HTRS V BTA.APP.(J&H.P.MAX.) .50 D LICENSE NO.
MOTORS: OVER NOT OVER H.P. DISTRICT NO. GROUP ZONE P OCESSE BY
0. 1 11.00 .(7 I
1 s 1.50 INSPECTION RECORD
8 8 2.00 a
8 1S 2.501 0
15 50 3.00 —
OC
grit' 44
50 100 5.00 - 1.-
t
SIGNS: NO.TRANS• ,t� D_
NO.LAMPS w 1 (('. •3 {.L.) ( �i �' Q3 'a.1Y'r-1 Z
SERVICE 0.SOOV-NOT OVER 200A 1.00
SERVICE 0-800V-OVER 200 A. 2.00 (JDA
SERVICE OVER 800V 5.00 -y
MISC.
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE 149 rs
1 HEREBY ACKNOWLEDGE.THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IB CORRECT AND.AGREE TO COMPLY CONDUIT-
WITH ALL. COUNTY ORDINANCES AND STATE LAWS REGULATING• pp 1'
ELECTRICAL WIRING. WIRING \
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERE6 AND/OR t/
LICENSED AB REQUIR BY Lob ANGELES LINTY AND STATE OF FIXTURES 4'/�f' '(U&!OAAA
CALIFORNIA OR TN Ah�THE LEGAL O ER OF*THE ABOVE t '
DESCRIBED 1 911DEN ALv RddERTY. POWER •�y ��s ,`
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITTEE J,
FINAL ! :k
K MO'T� A UR C. VETT
CK MO CA8FI SUPERVISING ELECTRICAL ENGINEER
b IUU 4 4 7 2 OCT 2. 2 D 1 1.1 0