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'OASSS CEBOS 10 60 APPLICATION FOR ELECTRICAL PERMIT 1
COUNTY OF LOS /ANGELES
DEPARMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
PERMIT FEES OWNER
I T E M NUMBER EACH FEE MAIL
[c7XTURES
$
S ADDRESS
LIGHTSCE SW lO CITY TEL NO
10
CLO DRYERS rRicELECTRIQCIAn _ CRHEATERS O ADDRESSS Z SPACE HTRS DISHWASHERS
CI TEL NOA t
GARBAGE DISPOSER69 llam_. �/1- STATE p p
WASHER STA COOKING UNITS r 25 LICENSE NO 178987
MOTORS OVER INC H P DIST ICT NO GRUP ZONE P CESSED Y
0— 1/2 2 5 !
1/2- 2 50 INSPECTION RECORD
2— 5 too
O
5— 15 150 U
9x
15— 50 230 O
50— 200 Soo
SIGNS
NO TRANS
yNy
NO LAMPS L
SERVICE 0 600V 100 Q 6
SERVICE OVER 600V 500
MISC
WIRING PERMIT 1 00 O
FIXTURE PERMIT 1 00 �° Q tv
SUPPLEMENTARY PERMIT 50
TOTAL FEE $ Q
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR S SIGNATURE
AND STATE THAT THE ABOVE 1S CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING WIRING TI
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LIl� A A c
CENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES L`-
CALIFORNIA OR
THA 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESI DEN L PROPERTY POWER 1 i
SIGNATURE UTILITY CO NOTIFIED / r OZ
OF PERMITTE FINAL V
fumssmaffill2ba= -111Wf9 ;4� -
(DATION ARTHUR C VETT
cK MO CASH SUPERVISING ELECTRICAL ENGINEER
"j__3 7 8 7 t� �� D 9 5