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76ABGS CES06 9 57 APPLICATION FOR R ELECTRIC PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING �1
BUILDING AND SAFETY DIVISION ADDRESS 4 I
JOHN A LAMBIE COUNTY ENGINEER
CASSATT D GRIFFIN SUP T OF BUILDING LOCALITY �� t I
NEAREST
;750
NT TO FILL IN CROSS ST
PERMIT FEES
NUMBER EACH FEE OWNER
FW
$ $ MAIL
10 ADDRESS
10 CITY TEL NO
S b ELECTRIC//I��AN (�
T E R H50 ADDRESS LSD jS
ELEC SPACE HTRS DISHWASHERS
GARBAGE DISPOSERS AUTO I CITY TEL O NI--76-73
WASHERS STA COOKING UNITS 25 STAT // 3 /
LICENSE NO �7
MOTORS OVER INC H P
O — 1/s 25
DIST RIC NO GROUP ZONE READY FOR INSPECTION
� —(I
1/2 — 2 50 l
2 — 5 100 INSPECTION RECORD
5 — 15 150
15 — 50 250
50— 200 500
SIGNS NO TRANS
NO LAMPS
SERVICE O 600V 100 G o
SERVICE OVER 600V 500
MISC
WIRING PERMIT 100 ( UU
FIXTURE PERMIT 100
SUPPLEMENTARY PERMIT 50
TOTAL FEE $ sd APPROVALS
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION ATEJ INSPECTOR S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT S /
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING WIRING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE POWER
DESCRIBED RESIDENTIA OPER
SIGNATURE UTILITY CO NOTIFIED /
OF PERMITTE 1
FINAL
Yf4MATION ART URC VEIT
cK MO CASH SUPERVISING ELECTRICAL ENGINEER
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76A663 CE806 1 67 APPLICATIONrOR EL CTRIC PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER FADDRE
ING
BUILDING AND SAFETY DIVISION JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUPERINTENDENT OF BUILDINGITY
ST
FOR APPLICANT TO FILL IN ST
RECEPT 1 TOTAL NO EACH FEE
I OUTLETS FIRST 20 $20 $ OWNER
LIGHT J} MAIL
SWITCHADD L f0 ADDRESS
OVER 20
TOTAL FIRST 0 20 CITY TEL NO
LIGHTING FIXTURES
FIXTURES ADD L
I OVER 20 10 CONTRACTOR
RANGES DRYERS WTR HTRS 100 ADDRESS Q
GARB DISP STA COOK W,! 07O
CIT TEL NO-
DISHWASH AUTO WASH STA E
SPACE HTRS STA APDL so LICENSE NO
MOTORS OVER NOT OVER HP DISTRICT GROU ZONE I P E SprD BY
O 1 100 t V
1 3 150 INSPECTION RECORD
3 8 200
S 15 250
15 50 300 d
50 100 Soo 0
SIGNS NO TRANS
NO LAMPS 0
O
SERVICE 0 600V NOT OVER 200A too
SERVICE O 600V OVER 200 A 200 d
N
SERVICE OVER 600V 500
OTHER (SEE COMPLETE FEE SCHEDULE)
PERMIT ISSUING FEE 200 Q
SUPPLEMENTARY PERMIT ISSUING FEE 100 APPROVALS OAT! INSPECTOR a SIGNATURE
TOTAL FEE $ Q
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION UN DERS LAB WORK
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ROUGH CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING WIRING
1 HEREBY CERTIFY THAT AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO POWER
RESIDE IN THE ABO DESC BED R IDENTIAL PROPERTY
SIGNATURE UTILITY CO NOTIFIED )9II
OF PERMITTEE
FINAL
OCKMOIDATION JOSEPH C ROOHAN
CASH SUPERVISING ELECTRICAL ENGINEER
MO CASH
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