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"��^^��O6o^� ■ APPLICATION FOR PERMTf
DEPARTMENT OF QG AND SAFETY ELECTRIC i
COUNTY OFF LOS LOS ANGELES
WILLIAM J. FOX, CHIEr ENGINEER
FOR AP.,PLICANT TO FILL IN DIBTRI NO. GROUP ZONE PERMIT NO.
ELECTRICIAN / 3 2 4.6
ADDwCBB REO[IV[D BY rIRHT DY ran INSPECTION
DAT[ ISSUED
CITY TEL NO
COUNTY LICENBCO q 0 JXPIRKS BUILDING
PESMTT FEES ADDRcee
NUMBER EACH
perLOCALITY
O
LIGHT OUTLETS NEAREST
RECEPTACLEB CROSS Sr.
WALL SWITCHES OWNS C
TOTAL OUTLETS 6o MAIL
ELEC. RANGES 425 ADDRIM Ca
[LEC HEATERS 78 CITY TEL N4
rIKTURW 6 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS t
BC. APPLICATION AND STAT[ THAT THE ABOVE IS CORRECT Q
NUMBER Or LIGHT CIRCUITS AMC ACR[[ TO COMPLY WITH ALL COUNTY ORDINAHO[B
NUMBER Or RECEPTACLE CIRCUITS AND STAT[ LAWS REGULATING ELECTRICAL WIRING.
MOTORS 1 CERTIFY THAT 1 PCMB THE ABOVE VALID LOB
NuHlq[wHCRB!PLMR rE
C ANGELS COUNTY LICKHM OR 1 AM THE LEGAL OWNER
N[w Mw HP ov[w Iwo wADw Or THE RESIDENTIAL PROPERLY DESCRIBED ABOVL
ya • ilaw IIS SIGNATURE Cry//
vs 9 60 P[RMITrrr /ITP
a e 10O INSPECTION RECORD
e to 1 60
16 60 250
6G 700 600
0
700 SCO luau J
6DD lOOO 16 DO =
OVEw 10® 7400 0
M G SCT/FREQ. CHANGER-HP R
WELDERS'AO-KVA O
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (76 or owlY)
MOVED MOTORS (76 Or CwIG)
HIBO
BIONS
M4 MO TRANS. APPROVALS
O NO LAMPS _
roll CAON PERMITt DATE INBPECTCR'S NAM[
WIRING Bl OO 10 (7 CONDUIT Z — —
►IKTUREB $1.00 00 WIRING
SUPPLEMENTARY 60 rI)rrURCS
POWER
TOTAL FEE B unuTYaD NDTIncD
rINAL
7"ea ey �
7°•663 DE.°° 4-68
APPLICATION FOR ELECTRICAL PERM
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
LDING
BUILDING AND SAFETY DIVISION A
DDRESSJOHN A LAMBIE COUNTY ENOINEER
COLEMANW JENKINS, SUMAINTEND.NTOFBUILDING
NEAREST
FSWITCH—
APPLICANT TO FILL IN CROSSST
NO A
f OWNER
MAIL
L FIRST 20 20 ADDRESS
OVER 20 10 CITY TEL NO
PLAN CHECK
L FIRST 20 20 APPLICANT
OVER 20 10 ADDRESS
RANGE_ORYER_WTR HTR CITY TEL NO
STA COOK_DISP _F A U CONTRACTOR
SPACE HTR _AIR COND _ ADDRESS l I I
CLOTHES WASH _DISHWASH CITY ^ TEL NO
FAN_OTHER 1 00 LICENSE NO / / CLASS Gyo
MOTORS TRANSFORMERS RATING `
IND HEATERS ETC HP KW KVA I HEREBY ACKNOWLEDGE THAT I HAVE READ TN13 APPLICATION
SIZE Q TYPE OVER TO
AND STATE THATHE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNT TY ORDINANCED AND STATE LAWS REGULATING
E LECTR IAL WIRING
O - 1 1 00
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
I 10 3 00 LICENSED AS REOUIRED BY LOS ANGELES COUNTY AND STATE Of
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO `r
10 $O S 00 RESIDE IN THE ABOVE DESCP RESIDENTIAL PROPERTY d
SO - 100 _1000 SIGNATURE
U
OF PERMITTEE Gd'fKr'1• a
O
100 - 500 1500 G~.D
slcN c•s DIST�I CT O G Z PR SSED BY 1,.1
TUBE OR
SIGN AND ONE CIRCUIT 3 00 I V
MAROUEE ADDITIONAL CIRCUITS I O° /
NOTES 7 �/� �/<� ...r
SERVICE NOT OVER SOO VOLTS OR 2GO AAF 2 00 nom/ �. 0/ 3'X __/
SERVICE OVER 600 VOLTS OR 200 AMP S 00 -` -
TEMP SERVICE POLE Q APPURTENANCES 3 00 APPROVAL$ DATE INSPECTOR S SIGNATURE
TEMP POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
PERMIT FEE (SUB TOTAL) WIRING
FIXTURES
PLAN CHECK FEE (SO% PERMIT FEE) POWER AUTHORIZED
PERMIT ISSUING FEE r20 4 U T I L I TY C O NOTI F I E D SUPPLEMENTARY PERMIT ISSUING FEE FINAL
TOTAL FEE JOSEPH C ROOHAN
SUPERVISING ELE CAL ENGINEER
PLAN CHECK VALIDATION CK M G CASH PERMIT VALIDATION CK M G CASH
1 1 6 0% JLL28 2 D 4OD9- /Q
WE MIX OF APPLICATION FOR COMPLETE FEE SCHEDULE
I
TSAGSS CKSOG ID pS APPLICATION FOR ELECTRIC PERMIT 1
BMDING AND SAFETY DMSION
DEpartmenl of Camay E°°ID'°` ABUILDING -T
DDRESS G +
C of Lo.angel..
JOHN A LA 1&COUNTY ENa1NEER I
GSEATT D. aR/FEIN !UP T OP aUILDING LOCALITY L
N8AR2HT
FOR APPLICANT TO FILL IN
C:
BD
PERMIT FEES oWNE / F
LIMBER R[CEPTACLU .WITCHES
NUNp[K 1 T 8 M EACH PQ6 MAIL
ADDRESS
TOTAL OUTLET! � 10 s O �
$LEC URGES WATER HEATERS CITY KA TEL
CLOTHES DRYERS EO ELECTRICIAN
SLSC $PACK HEATER/ STAT T COOK
IRS UNITS GARBAGE DISPOSER$ ADDRESS
AUTO WASHERS DISHWASHER 2E I
1
LIGHTING FIXTURES 10 CITY T NO
MOTOR! STATE
LICENSE NO
HORSEPOWER
H P OVER INC DISTRICT NO G READY row IRSreR ION
.LESS 2D Poo A- 1
2 Eo INSPECTION RECORD
2 U 100
E IE 1 WO
15 !0 250
EO 200 000 ./
MIN T OLE
=,7x /zif7vp
SIGNSI NO TRANS
NO LANPS
SERVICE 0-000V 100
SERVICE OVER GOOV 000
WIRING PERMIT I DO
FIXTURE PERMIT 1 00
SUPPLEMENTARY PERMIT So 'piAPPROVALS
TOTAL FEE • DATE INSPECTOR S SIGNATURE
1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUITC-7 1/04u
AllWITH ALL COUNTY ORDINANCES AND 6TATE LAWS REGULATING I T
ELECTRICAL WIRING WIRING
LICENSED
I HEREBY CERTIFY THAT 1 AN PROPERLY REGISTERED AND/OR FIXTURES
AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AN THE LEGAL WEER THE BOVE POWER
DESCRIBED RESIDENTIAL PROPERTY
SIGNATURE P UTILITY CO NOTIFIED
OF PERMITTE FINAL
(JOHN A LAMBIE VALIDATION ARTHUR CT
COUNTY ENGINEER CK Mo CASH SUpmVIYINa LECTRIGL ENa1NE2R
JC' o0621—� JUL 25 2 280
76Aw Dee IIA 7-111I APPLICATION FOR PERMT
DEPARTMENT OF BUMDING AND SAFETY
COUNTY OF LOS ANGELES ,4 ELECTRIC 1
WILLIAM J. FOX. CHI[I ENGINEER
FOR APPLICANT TD FILL IN DISTRICT NO. GROUP ZONE PERMIT NO.
ELECTRICIAN
r RECEIVED, BY READY ►OR DAT[ ISSUED
ADDRESS aC FIR N
COUNTY LICENSE NO EXPIRES ,B�,UUILDIN � G
PERMIT FEES
NUMBER EACH FEE LOCALITY ✓.�.yJ
LIGHT OUTLETS NEAREST
RECEPTACLES CwOee BT
WALL SWITCHES OWNER
TOTAL OUTLETS BO MAIL / I,
CLEO RANGES Sp ADDRESS
CLEC HEATERS 2M CITY TEL NO
FIXTURES 5 1 HEREBY AOKNoWLEDGE THAT 1 HAVE READ THIS
misc APPLICATION AND STAT[ THAT THE ASDV[ IS CORRECT
NUMBER Or LIGHT CIRCUITS AND AOR[[ TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER or RECEPTACLE CIRCUITS AND STAT[ LAWS REGULATING ELECTRICAL WIRING
MOTORS I CERTIFY THAT 1 POSSESS THE ABOVE VALID LOS
NDME[R [ADH
DHYER SNC ORSEPOWER "BELCH COUNTY LICENSE. OR I AN THE LEGAL OWNER
PEE or THE RESIDENTIAL PROPERTY DESCRIBED ABOVE
N[w Mw HP
Va f w[ a BB SIGNATURE Or
1/2 S 60
PERMII'1'[L�
s S 1D INSPECTION RECORD
B IS 1 SC
in BO 250
Bo SOC B GC
200 BOO law] a
BOO IOOD 1500 Z
ov[R low sa Go p
M 0 acr/rRKQ CHANBCR-HP C
WELD[RBI AO-KVA O
BEN[RATORE - KW
TRANSFORMCRB - KVA
TEMP MOTORS (76 OF Gala)
MOVED MOTORS (711or DRID)
RC
SIGNS
Na NO TRANM APPROVALS
NO LAMPS
►OR EACH PERMIT. DATE INSPECTOR'S NAME
WIRING $100 CONDUIT
rIXTURCo S1 DC WIRING
L BO rIXTURCO
POWER
TOTAL FEE • / �.� UTILITY Do NOTir1ED - — 1-
FINAL /—) 7