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76A663 CE806 12 65 APPLICATION FOR ELECTRIC PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS CNn 'YIC�
JOHN A LAMBIE COUNTY ENGINEER /
COLEMAN W JENKINS SUPERINTENDENT OF BUILDINGLOCALITY r y
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
RECEIPT Is)) 1 TOTAL No EACH FEE
OUTLETS 1 FIRST 20 $20 $ OWNER LI
LIGHT J}
SWITCH 4 ADD L I 1O AD
I DRESS
OVER 20 r
GHTING
LTOTAL FIRST 201 20 CITY TEL NO
I 1 FIXTURES
FIXTURES )( ADD L I CONTRACTOR��� I—L.CL
OVER 201 10
RANGES 1 DRYERS I WTR HTR9 07 . 100 ADDRESS _ �./ �' v / 1 X "
GARB DISP STA COOK1 1�n � " I L, t1C
CITY I �.J ,--> V TEL NO J �(
DISHWASH AUTO WASH STATE
SPACE HTRS STA APPL 50 LICENSE NO 1`? 5
MOTORS OVER NOT OVER H PDI R T G P Z NE PR D
O 1 100 /
1 3 150 INSPECTION Hct-)6 IL
O
3 S 200 V
ix
8 15 250 rO
15 50 300 W
a
50 100 500 N
Z
SIGNS NO TRANS
NO LAMPS
SERVICE 0 600V NOT OVER 200A 1 00
SERVICE 0 600V OVER 200 A 200
SERVICE OVER 600V 500
OTHER (SEE COMPLETE FEE SCHEDULE)
13--o w
CY, /J
3
PERMIT ISSUING FEE 2 00
SUPPLEMENTARY PERMIT ISSUING FEE 1 00 APPROVALS DATE INSPECT O sI GNATURE
TOTAL FEE
1 HEREBYL
LEDGE THAT I HAVE READ THIS APPLICATION UNDERS LAB WORK
AND STATE E ABOVE IS CORRECT AND AGREE TO COMPLY ROUGH CONDUIT ,
WITH ALL ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING
1 HEREBY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED ARED BY LOS ANGELES C NTYSTATE OFCALIFORNIAT I AM THE LEGAL OWN OF AN INTEND TO POWER
RESIDE IN E��BF.Q�RE SIDEN ALPR TYSIGNATURQ` . UTILITY CO NOTIFIED
OF PERMI
FINAL
OLIDATION JOSEPH C ROOHAN
KMO CASH SUPERVISING ELECTRICAL ENGINEER
LAo3507% JdL15 2 D 1590,