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D88•SA 8•95 FL ,APPLICATION FOR\ ELEC YY IC PERMIT 1
DIVISION OF BUILDING AND SAFETY
Deportment of County Engineer
County of Los Angeles BUILDING
WM.J. FOX,COUNTY ENGINEER ADDRESS
CASSATT D.GRIFFIN,SUPT OF BUILDING A
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PERM FEES- CROSS ST.
NUMBER EACH FEE
LIGHT OUTLETS OWNER
RECEPTACLES MAIL f
ADDRESS
WALL SWITCHES
r` TOTAL OUTLETS r 5¢ $ Q CITY . 1-, EL.NO.
ELEC.RANGES 25 ELECTRICIAN
_ELEC.HEATERS 25 ADDR S
KW EA CI _ _ $ TEL.NO.
6�
FIXTURES S LICENSE NO. C:y
NUMBER OF LIGHT CIRCUITS - DISTRICT NO. I GROUP I ZONE I READY FOR INSPECTION
NUMBER OF RECEPTACLE CIRCUITS
MOTORS
NUMBER HORSEPOWER FEE INSPECTION RECORD
NEW MVD. HP OVER INC. EACH
I12&LESS
' 2 .50
2 5 1.00
5 15 1.50
15 50 2.50
50 200 5.00
0,1
r MISC.
Ohli
NO.SIGNS NO.TRANS.
'rK NO.SIGNS NO.LAMPS
FOR EACH PERMIT: �.
4
WIRING 51.00
FIXTURES $1.00
1 SUPPLEMENTARY .50 APPROVALS
TOTAL FEE $ v DATE INSPECTOR'S SIGNATURE
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CONDUIT Xot h.-
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING " WIRING
ELECTRICAL WIRING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANAELES COUNTY AND S 7E OF
CALIFORNIA OR THAT AMIE. GA OWNER OF THE E POWER
DESCRIBED RESIDE NTI LRO
SIGNATURITE fid!! G ��p/��At?fl� i `I UTILITY CO.NOTIFIED
OFPERM FINAL
WILLIAM J.FOX.COUNTY ENGINEER VALIDATION A.C.VEIT,CHIEF ELECT.INSPECTOR
:_ 1 2'1 9 HU14 DEC 22 2 1.1 0 �
78A683
3-SS ■APPLICATION O■ \ ELECTRIC PERMIT
1
DBS.SA
DIVISION OF BUMPING AND SAFETY
• Deportment of County Engineer
Couaiy of Los Angeles BUILDING
WM.J. FOX.COUNTY ENGINEER ADDRESS
CASSATT D.GRIFFIN.SUPT OF BUILDING
LOCALITY 1
FOR APPLICANT TO FILL IN NEAREST
PERMIT FEESCROSS ST.
NUMBER EACH FEE
LIGHT OUTLETS OWNER
MAIL Die
RECEPTACLES #1E
ADDRESS
WALL SWITCHES
TOTAL OUTLETS $ CITY TEL.NO.
y IkLEC.RANGES 25 ELECTRICIAN '
_ELEC. HEATERS 25 ADDRESS
KW EA CIT TEL.NO t�
FIXTURES I 5 LICENSE NO.
NUMBER OF LIGHT CIRCUITS - DISTRICNO. GROUP Z/O}}NEJp READY FOR INSPECTION
NUMBER OF RECEPTACLE CIRCUITS � I � I �o/1
MOTORS yy`��IIuuJJ i/
NUMBER HORSEPOWER FEE INSPECTION RECORD
NEW I MVD. HP OVER INC. EACH
Yz a LESS S .25
116 2 .50
2 5 1.00
5 15 1.50
IS 50 2.50
50 200 5.00
MISC. 1,J `
i` NO.SIGNS NO..TRANS. 8,09,1/41 X AAI
NO.SIGNS NO'.LAMPS
FOR EACH PERMIT: _ �r ; 1141
WIRING $1.00 /,/� 7
FIXTURES $1.00 / "' "�� �`P 4 y-Vjr ,
SUPPLEMENTARY .50 APPROVALS
TOTAL FEE S , ® p.DATE 1NSPE TOR'S SIGNATURE
1 HEREBY 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 �ryry—��j�j I�l� ��rA�
ELECTRICAL EREBY CERTIFY THAT I. AM PROPERLY REGISTERED AND/OR FIXTURES' 1' dJ S .�'dY �4 11/1'
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEG OWNER OF THE ABOVE POWER
DESCRIBED RESIDENTIAL PROPERTY
SIGNATURE UTILITY CO.NOTIFIED -
OF PERMITTEE FINAL
O •
WILLIAM J.FOX.COUNTY ENGINEER VALIDATION A.C.VEIT.CHIEF ELECT.INSPECTOR
�2 6 1 8 FEB 7 2 6.10 to