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APPLICATION FO R ELECTRIC PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE. COUNTY ENGINEER �I
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST '
PERMIT FEES CROSS ST. )
ITEM NUMBOWNERER EACH FEE MAIL
OUTLETS: $ $ / ADDRESS
LIGHTS RECEPT.• SW. .10 _
LIGHTING FIXTURES10 CITY TEL.NO.
ELEC.RANGES CLO.DRYERS ELECTRICIAN
AA��gyp` I C r
WATER HEAT ERS .50 ADDRESS / /V(} i, ��, /� (��c (� /'1 l•�G.
ELEC.SPACE HTRS. DISHWASHERS1
CITY TEL. NO.
GARBAGE DISPOSERS AUTO.-
STATE
WASHERS STA.COOKING UNITS .25 LICENSE NO. G•� �/
MOTORS: OVER INC. H.P. DIST,5R-I T NO. GROUP ZONE PR/gC,ESSED B J'
0— 1/2 .25
V I l 14 7 t
1/2— 2 so INSPECTION RECORD
2— 5 1.00
5— .15 1.50
is— 50 2.50
50-200 5.00
SIGNS: NO.TRANS. �•
NO.LAMPS
SERVICE 0-600V 1.00 00
SERVICE OVER 600V 5.00
MISC.
WIRING PERMIT 1.00
a.
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT .50
TOTAL FEE
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY r
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT ./ // �,
ELECTRICAL WIRING.
IHEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR - WIRING
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL /PROPERTY. POWER
SIGNATURE ii�/� 1
OF PERMITTEE_ iL L/,,q-�f.:. UTILITY CO.NOTIFIED i ,y yfp
FINAL V(/Y /6 e
OF DATION ARTHUR C.VEIT,
cK MO CASH SUPERVISING ELECTRICAL ENGINEER