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7e " Pee a 7-01 APPLICATION FOR PERMIT
DEPARTMENT OFNG AND SAFETY ��������
'COUNTY OFF LOS LOS ANGELES
WILLIAM J FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTR�NO. OR ( ZON% ;ERM? NO.
�,(.///�� 3 yG. f�
ELECTRICIAN
qEp[IV[D BY READY FOR DATE ISSUED
ADDRESS FIRST IN,B�P[6TION
CITY
CITY TEL. NO
COUNTY LICENSE NO. EXPIREB BUILDING
ADDRESS gP
PERMIT FEES Alend
NUMBER EACH ►[[ LOCALITY
LIGHT OUTLETS NEAREST
ROBS BT
RECEPTACLES
WALL SWITCHES OWNERiJYJJLO �f//C,
TOTAL OUTLETS Sc B MAIL
ELEC RANGES as ADDRESS
ELEC HEATERS aS CITY q TEL. MO
FIXTURES S 1 HEREBY A KNOWLEDGE THAT I MAV[ READ THIS
MIeO APPLICATION AND STATE THAT THE ABOVE le CORRECT
NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER Or RECEPTACLE CIRCUITS AND STAT[ LAWS REGULATIND ELECTRICAL WIRING
MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB
Nuwe[a HORB[POWES r[[ ANGELES COUNTY LICENSE. OR 1 AM THE LEGAL OWNER
N[w MVo HP PV[n INP EAPH Of THE RESIDENTIAL PROPERTY DESCRIBED ABOVE
as SIGNATURE OF
7 SD P[RMITT[
a S 100 INSPECTI RECORD
_ B is 150
10 SD 250 AI
SO 200 500
_ 100 am 1000 J
SOD 1000 1s DD Q
2
OVER 1 W0 ap 00 �
M G BET FRES CHANGER-HP
WELDERS AC-KVA O
GENERATORS - KW
TRANSFORMERS - KVA
TEMP MOTORS (76 Or oRIG)
MOVED MOTORS (75 or onto)
I
SIGNS n
NR NO TRANS. APPROVALS
MO NO LAMPS
FOR EACH PERMIT[ DAT[ INSP[OTORIS NAM[
WIRING 81,00 N CONDUIT
FIXTURES Bl OC WIRING
SUPPLEMENTARYSG FIXTURES
POWER
TOTAL FEE • y UTILITY CO.NOTIFIED
FINAL
76Aee3 Ceeoe i ee y
APPLICATION FOR ELECTRIC PERMIT 1
BUILDING AND SAFETY DIVISION
Depcor went of County Engine BUILDING r
County of Los Angeles ADD"% J I
JOHN A LAMBIE COUNTY ENGINE" ��
WBBATT D GRIFFIN SUR i OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PERM FEES CROSS 8T
NUMBER OWNER
_ji LIGHT OUTLETS MAIL
Al ,
DDRESS
RECEPTACLES rr
Z WALL SWITCHES FEE CITY TEL NO
TOTAL OUTLETS st s ELECTRICIAN
ELEC RA GES 20 ADDRESS
ELEC ♦ 25 CITY TEL NO
KW EA STATE
FIXTURES D LICENSE NO
MOTORS DISTRICT NO GROUP ZONE READY FOR IN81ECT1OR
NUMBER HORSEPOWER FEE
NEW I MVD HP OVER INC EACH
•LESSf 2s INSPECTION RECORD
z eo
2U 1 00
D fD 1 60
1e Is 2 SO
50 200 500
MISC
NO SIGNS NO TRANS
NO SIGNS NO LAMPS ,
FOR EACH PERMIT
WIRING PERMIT $100
FIXTURE PERMIT $I CIO
f[Tfnn
SUPPLEMENTARY 00 APPROVALS
TOTAL FEE DATE INSPECTOR 3 SIGNATURE
IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION CONDUIT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING
ELECTRICAL WIRING FIXTURES
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF POWER
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PRUTILITY CO NOTIFIED
SIGNATURE OP
OF PERMITTlE FINAL
o NA MBIE VAMA Ag ARTHURN VETT
COUNTY N MBIE /�\tT�,^j�/ ARTH SUPERVISING ELECTRICAL ENGINEER
CK MO
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