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s7aam ueeu 7-e1 APPLICATION FOR PERMIT
~SDEPIRTMENT OF BUILDING AND SAFETY
COUNTY OF LOS ANGELES ������_� 1
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANTTO FILL IN DISTR NO. GROUP ZONE PERMIT NO.
ELECTRICIAN '1 /
R[a[IV[D BYY FOR DAT[ ISSUED
ADDRESS /� FI INBPEOTIOM
CITY L;rl TEL NO �' '�/�AA ` •�
COUNTY LICENSE N0 EXPIREDBUILDIIN / 'I
MIT
PERFEES �'
FEE -72NUMBER EACH LOCALITY
LIGHT OUTLETS NEAREST
RECEPTACLES CRUMB ST 11 �X/
WALL SWITCHES OWNER W, r / 3'✓n1* 4 __
TOTAL GUTLCTBse B y MAIL .C��/
EL[6 RANGES 9s ADDREBB
ELEC HEATERS 35 CITY C TCL NO
FIXTURES 6
1 HEREBY ACKNOWLEDGE THAT I NAVE READ THIS
WOO 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 LOB
Nuwe[q HORSEPOWERF[[ ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
NEW Mw HP OVER IHS [ADH OF THE RESIDENTIAL PROPERTY DCDCRIAPD ASOV[.
_ I/ A LERF 8 Zs SIGNATURE OF
va 9 - 50 PERMIT'SE
z a 1Do INSPECTION RECORD
s is 1 so
is so 230
_ eD zoo 500
200 SOD 1000 J
600 1000 is 00 Z
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OVER 1000 2000
M O SET/rREQ CHANGER-HP
WELDERS AC-KVA O
GENERATORS - KW
TRANSFORMERS - KVA _
TEMP MOTORS (75% OT GRIM)
MOVED MOTORS (75% Or ORIO)
SIGNS
NO NO TRANS
APPROVALS
NO NO LAMPS
FOR EACH PERMITS D E INSPECTOR'S NAM[
WIRING 61 DO CONDUIT
►IXTUR[D S1 DO Q WIRING ,v L
SUPPLEMENTARY BO FIXTUREB
POWER
TOTAL FEE • 1' UTILITY aO NOTIFI[O G�s�
7 FINAL
COUNTY OF LOS ANGELM APPLICATION FOR PERM
DEPARTMENT OF ILCOUNTY ENGINEER ELECTRIC 1
DIVISION . F 3L COMMiG 6 SAFETY
WII.LIAM . POL COIIENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO GROUP I ZONE PERMIT NO
ELECTRICIAN r /
ADDRESS RffCg!lw BY READY FOR DATE ISSUED
NO 441� PIRDT INBPHCTION ,9--2Z—J7
CITY TIO-
COUNTY LICENSE NO EXPIRES BUILDING
PERMIT FEES ADDRESS
FE[
NUMIISR EACH LOCALITY
LIGHT OUTLETS NEARZST
RECEPTACLES CR
WALL SWITCHES OWNER
TOTAL OUTLET[ Da
MAIL
ELEC RANGES IID ADDRESS
ELEC HEATERS 26
FIXTURES D CITY TEL NO
MISC 115V1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
NUMBER OF LIGHT CIRCUITS APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMSE OF RECEFTACL6 C RCU AND STATE LAWS REGULATING ELECTRICAL WIRING
MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOB
NYM"R HDRSQ -- FEZ ANGELES COUNTY LICENSE, OR I AM THE LEGAL OWN[
N[w Mvo HF OV611 IMG uc11 OF THE RESIDENTIAL PRWZR DZSCRIBZD ABOVE
•Wa 6 IIS SIGNATURE OF
[ EO PERMITTER
II D 1 00 INSPECTION BECOBD
D IS I DO
ID DO a DO
DO POO D 00
s00 SOO 10 Do J
600 1000 Is DO
Z
OV ZR 1000 IIO 00 �
M O SET FRED CHANGER-HP Q'
WELDERS AC-"A O
GENERATORS KW
TRANSFORMERS-HVA
TZMP MOTORS 7 Or OEID
MOVED MOTORS (76 or OaIG 1
MISC
SIGNS
NO NO TRANS APPROVALS
NO. MO LAMPS
FOR EACH PERMIT D INSPECTOR'S NAME
WIRING $100CONDUIT
FIXTURED 0100! WIRING �/�L7 11
SUPPLEMENTARY SOFIXTURES
POWER
TOTAL FEE UTILITY CO NOTIFIZDFINAL iE
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