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76A663 CE6061069 APPLICATION FOR ELECTRIC PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING �-�`/�
BUILDING AND SAFETY DIVISION ADDRESS LESS 4.A)OR o
JOHN A LAMBIE COUNTY ENGINEER 1
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY 6 L(7 C T
FOR APPLICANT TO FILL IN NEAREST
PERMT FEES CROSS ST LASTUNAS
I T E M NUMBER I EACH FEE OWNER U 1b S M
- MAIL
OUTLET $ $ ADDRESS L
LIGHTS RECEPT BW 10
LIGHTING FIXTURES f0 CITY L&- C TEL NO
1XIELEC RANGES CLO DRYERS ELECTRICIAN
WATER HEATERS 50 ADDRESS
ELEC SPACE HTRS DISHWASHERS CITY TEL NO
GARBAGE DISPOSERS AUTO tiSTATE
WASHERS STA COOKING UNITS 25 �IICENSE NO
MOTORS OVER INC H P I DISTRICT G OUP I ZO E P ESSED BY
O— 1/2 25 , (l
1/2— 2 50 INSPECTION CORD
2— 5 100 I
5— 15 ISO
15— 50 250
50-200 500
SIGNS NO TRANS
NO LAMPS
SERVICE O 600V too
SERVICE OVER 600V 500
MISC
WIRING PERMIT 1 00
FIXTURE PERMIT too
SUPPLEMENTARY PERMIT SO
TOTAL FEE $
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT
ELECTRICAL WIRING
I HEREBY CERTIFY THAT I 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 A50VB
DESCRIBED RESIDENTIAL PROPERTY POWER
SIGNATURE ^ UTILITYCO NOTIFIED
OF PERM ITTE
FINA
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CK MO CASH SUPERVISING
RVISING ELECTRICAL ENGINEER
CK MO
Uy ,03 2 b 9w JUL 7 2 0 2 60 N