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76A663-CE806 6/63 APPLICATION FOR ELECTRICAL PERMI
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS J.�
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY 74,
NEAREST
FOR APPLICANT TO FILL IN cRoss fir. {C V
RECEPT. TOTAL NO. EACH FEE
LIGHT OUTLETS FIRST 20 $20 $ OWNER >
MAIL
` ADD'L ADDRESS
SWITCH. / , OVER 20 •+0
TOTAL CITY TEL. NO.
LIGHTING t FIRST 20I .20 �
FIXTURES / ADD'L 10 ELECTRICIAN
------LLLL _ 0 V R 2 0
RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS D
GARB.DISP. STA.COOK
CITY y1e4p y TEL. NO. d oZ C
DISHWASH. AUTO.-WASH. STATE f
SPACE HTRS. STA.APP.I-/i H.P.MAX.) .50 LICENSE NO. (p
MOTORS: OVER NOT OVER H.P. DISTRICT �O G Ol1P E P ESSED �7Y
✓ / [idZ�c
O 1 1.00 Z.
+ 3 1.50 INSPECTION RECORD
3 8 2.00 }
2
80 2.50 Q
15 50 3.00 d'
0
50 100 5.00
V
Lu
SIGNS: NO.TRANS- D.
NO.LAMPS N
Z
SERVICE 0.600V-NOT OVER 200A 1.00
SERVICE 0.60OV-OVER 200 A. 2.00
SERVICE OVER 600V 5.00
MISC.
PERMIT ISSUING FEE 2.00 �u
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
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 CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR AT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RES E TIAL PROPERTY. POWER
SIGNATURE l �� UTILITY CO.NOTIFIED
OF PERMITT
FINAL
VALIDATION ARTHUR C. VEIT
CK MO CA6H
SUPERVISING ELECTRICAL ENGINEER
3 3 6 9:o SLP 1 ? A 3.2 0—