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DOS-SA If•SS APPLICATION FOR ELECTRIC PERMIT 1 -
BS.
DIVISION OF BUILDING AND SAFETY
Deportment of County EngineerBUILDING
Cour of Los Angeles ADDRESS (ASO 5!/G TA.N'A
JOHN A.LABII;.COUNTY ENGINEER 6=4 kA f L
CASSATT D.GRIFFIN.SUPT CR HUILDIN6 LOCALITY
FOR APPLICANT TO FILL IN NEAREST
w PERM FEES CROSS ST. L JI
y NUMBER
OWNER
LIGHT OUTLETS
�. MAIL
RECEPTACLES ADDRESS
WALL SWITCHES FEE CITY TEL.NO.
TOTAL OUTLETS 5¢ $ ELECTRICIAN *r
ELEC.RANGES 25 ADDRESS r D 6,V ZU E G L
ELEC.HEATERS 25
iCM/ CITY G TEL.NO
e' STATE
44 FIXTURES g LICENSE NO. / +o
MOTORS FEE vTrj DISTRICT NO. IGRO!IPI 7QZONE8ADYFOAINSPECTION
NUMBER HORSEPOWER
NEW MVD. HP OVER INC. EACH INSPECTION RECORD =
2 .50
2 5 1.00
5 1.150
1550 2 80 =��'i�''l / C9"� //!b Lll]�1l '
SO 200 5.00 - f,
4777 T
MISC. &X V19Ce lAIX T29/G,
.40 14114PIA or—071 ?e6VB 4
NO.SIGNS NO.TRANS.
NO.SIGNS NO. LAMPS
FOR EACH PERMIT:
r e
WIRING $1.00 19 �P�� t�e� �J{�f �id✓/li�f'L���i
FIXTURES $1.00 �E ,,r
SUPPLEMENTARY .SO A
APPROVALS
TOTAL FEE $ DATE INSPECTOR'S 8 GNATURE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUITWITH ALL COUNTY Z -5
ELECTRICAL WIRING.ORDINANCES AND STATE LAWS REGULATING WIRING �' �(, f;► �tLlll'r
I HEREBY CERTIFY THAT I AHI PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AN THE LEGAL OWN R OF THE ABOVE POWER
DESCRIBED RESIDENTIAL OPER
SIGNATURE UTILITY CO.NOTIFIED r'� !'r(j1��1 �r�
OF PERMITTEE FINAL 7,/-6' 5-.:.Zv`v(11,
iOHN A.LAMBIE.COUNTY ENGINEERATION ARTHUR C.VEI.T.CHIEF ELECT.INSPECTOR
Cie 1140 CASH
I ACO 7 6 5 9 c APR 5.� U
�
9 2 cn
IBA663-CEBOS-7.56 APPLICATION FOR ELECTRIC PERMIT
BUILDING AND SAFETY DIVISION
Department of County Engineer BUILDING
County of Los Angeles ADDRESS O ' Sv L N
JOHN A. LAMBIE, COUNTY ENGINEER / / t
CASSATT D. GRIFFIN,SUPT OF BUILDING LOCALITY v
NEAREST � /y
FOR APPLICANT TO FILL IN cRoss ST.
PERMIT FEES
NUMBER OWNER tJ Z
LIGHT OUTLETS MAIL
ADDRESS
RECEPTACLES
WALL SWITCHES FEE CITY TEL.NO.
TOTAL OUTLETS @ 5¢ $ e- D
ELEC. RANGES 25 ADDRESS jD6 "' D C.2J
ELEC.HEATERS 25 CITY F 0)V TEL.NO. Aal L
KW EA STATE
FIXTURES 5 LICENSE NO.
i MOTORS DISTRICT NO. GROU �NE READY FOR INSPECTIOR
NUMBER MOR EPOWER FEE I
:/L t
NEW MVD. HP OVER INC. EACH
1h&LESS $ .25 INSPECTION RECOBD
Ih 2 .50.
2 5 . • 1.00
5 15 1.50
i
15 50 2.50. •
5.0 200 5.00
MISC.
• R,
NO.SIGNS NO.TRANS.
NO.SIGNS NO. LAMPS
FOR EACH PERMIT:
WIRING PERMIT $1.00 L �—
FIXTURE PERMIT $1.00
SUPPLEMENTARY .50 APPROVALS
TOTAL FEE $ DATE INSPECTORS SIGNATURE
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION CONDUIT / rI.N I.CiI
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WIRING
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. I
FIXTURES'
I HEREBY CERTIFY THATlRjft
PROPERLY REGISTERED AND/OR
LICENSED AS REQU B COUNTY AND STATE OF POWER
CALIFORNIA OR AT 0 THE ABOYE
DESCRIBED ESI TI UTILITY CO.NOTIFIED
SIGNATURE (J` �r•v .uyt�
OF PEFINAL
IOHN A.LAMBIE. VAIMA ` ARTHUR C.VEIT.
.OUNTY ENGINEER CK Mo ASH SUPERVISING ELECTRICAL,ENGINEER
i 6 9 7 0'U'-1-' APR C3 2 1.1 0,
76A663 CE 8668 10,77 APPLICATION FOR ELECTRICAL PERMIT
d COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER ADDRESS /��
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN LOCALITY M L� G 7-
New Residential Bldgs.&Pools EACH NO. FEE CROSS ST. /ff�L/>!
1 &2•Family,Sq.Ft. $ 025 — $ OWNER OR
Multi-fomily Sq.Ft. •02 — FIRM NAME �• SG%` J�/ / /
Residential Swimming Pools 25.00 MAIL
ADDRESS &050 (+ L. /ATa
-SU AJ ft
Outlets:RecLightASw. ITY ®j C—_C, Ly Tel.No.a 5•-
First 20 50 PLAN CHECK
Total No. Additional .30 APPLICANT
ADDRESS
Lighting Fixtures First 20 .50 CITY /� Tel.No. ,g n
Total No. Additional 30 APPLICANT /GU�L-• /�'rT /"
Fixed Appliances Not Over 1 HP ADDRESS , Cj,`�^e ,V�r
Range_Heater_D.W._ CITY�M,4 kaeC Tel.No. ,7,5
Oven.—Dryer_W.M. LICENSE OR / q
Top —FAU —W.H. REG.NUMBER lJ 3 Class.
Hood_Fan _Other- I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
Disp. _ Room Air Cond. 2.50 THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDIN.
ANCES AND STATE LAWS REGULATING ELECTRICAL WIRING.
Power Apparatus&Large Appliances
Size&Type HP,KW,KVA,or KVAR I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS
Up to 1 Incl. 2.50 REQTHEEIIRED 3Y LLEGALOWNS A THE ABOVE DESCRIBANDEDAT IOFNCI RRP RTY . THAT I AM
Over 1 to 10 Incl. 5.00 cC).�
Over 10 to 50 Incl. 12.50 PERMITTEE o_
Over 50 to 100 Inc. 25.00 SIGNATURE CD
e.�
Over 100 40.00 DISTRICT NO. �i BY h
Services
0.200 Amp.Under 600 V 12.50 INS CTOR'S
201.1000 Amp.Under 600 V 25.00 APPROVALS DATE SIGNATURE
Over 1000 Amp.or Over 600 V 50.00 TEMP.POWER POLE
10.00 UNDERSLAB WORK
Temp.Power Pole&Appurtenances
'Sign with One Branch Circuit 10.00 ROUGH CONDUIT
Additional Sign Branch Circuits 2'00 WIRING
Misc.Conduits&Conductors 10.00 FIXTURES
Other(See Complete Fee Schedule) POWER AUTHORIZED
UTILITY CO.NOTIFIED
FINAL 17 it `" ®'* ^P^
PERMIT FEE (Sub-Total) NOTES
L ` ` 1 y-J U
PLAN CHECKING FEE (One-Fourth Permit Fee) 1 _
PERMIT ISSUING FEE $7.00. _
TOTAL FEE 4-s?)
PLAN CHECK VALIDATION K. M.O: CASH PERMIT VALIDATION CK. M.O. CASH
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE