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6,663 CE806 5 62 APPLICATION FOR ELECTRI L PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS 5019 Baldw3.n
JOHN A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY Temple -Cit
NEAREST
FOR APPLICANT TO FILL IN CROSS ST L$ Rosa
RECEPT 2 TOTAL NO EACH FEE
LIGHT
1 OUTLETS FIRST 20 20 $20 O OWNER
:1 MAIL
ADD L ADDRESS
SWITCH13 51 OVER 20 10 30 0
LIGHTINGrTlOF
F)RST 201 20 o O CITY TEL NO
FIXTURES ADD L 1O ELECTRICIAN COnlee & Son Electric
OVER 20
RANGES CLO DRYERS WTR HTRS 100 ADDRESS1030 14, Grandview Ave,
GARB DISP1 STA COOK CITY ,SO. San Gabrie�EL NoAt.0-2007
DISHWASH AUTO WASHSTATE
SPACE HTRB STA APP (1/1 H P MA% 4 $O 2. )0
LICENSE N0137567
MOTORS OVER NOT OVER H P DISIBIV!�
GR ZO 7 P ED
0 1 100 l s
1 3 150 INSPECTION RECORD
3 6 200
8 15 250 d
O
15 50 300 u
OC
50 100 500 O
F-
SIGNS NO TRANS
NO LAMPS
a
h
SERVICE O 600V NOT OVER 200A 1 1 00 1 o O Z
SERVICE O 600V OVER 200 A 200
SERVICE OVER 600V 500
MISC
PERMIT ISSUING FEE 200 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 100
TOTAL FEE i 15
1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR S SIGNATURE
AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING -
ELECTRICAL WIRING WIRING •�t�' "' ,.�
I HEREBY CERTIFY THAT I S PROPERLY REGISTERED AND/OR
LICENSED A8 REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
P
CALIFORNIA OR THAT I AM HE LEGAL `NER OF THE ABOVE ra,r
DESCRIBED RESIDENTIAL OP RTY / POWER
9�.3
SIGNATURE UTILITY CO NOTIFIED ,,vvgg
OF PERMITTEE FINAL D 14--9
VALIDATION ARTHUR C VETT
� MO CASH SUPERVISING ELECTRICAL ENGINEER
LAC0 7 7 2914—D DEC S 2 A 1 5.2 QQ