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76AS63 CES06 6 57 APPLICATION FOR ELECTRIC PERMI"I i 1
COUNTY OF LOS ANGELES comailmlMill
DEPARTMENT OF COUNTY ENGINEER FA
UILDING
BUILDING AND SAFETY DIVISION DDRESS
JOHN A LAMBIE COUNTY ENGINEER
CASSATT D GRIFFIN SUP T OF BUILDING OCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
PERMIT FEES
LIGHTS 10 RECEPTACLES SWITCHES OWNER
NUMBER ITEM EACH I FEE MAIL
Zl-
TOTAL OUTLETS $ 10 $
ADDRESS
ELEC RANGES WATER HEATERS CITY TEL NO
CLOTHES DRYERS SC ELECTRICI
ANI
p ELEC SPACE HEATERS STAT Y COOK
/ ING UNITS GARBAGE DISPOSERS ADDRESS
AUTO WASHERS DISHWASHER 25
OW LIGHTING FIXTURES 10 CIN TEL NO
MOTORS STATEC-
LICENSE NO v
HORSEPOWER
H P OVER INC DISTRICT NO GROUP ZONEREADY FOR INSPECTION
1/2&LESS 25
1/2 2 so INSPECTION RECORD
2 — s 100
S — is 1 1550 — 3' D OTS®
is — so 250
50 200 500
MISC
SIGNS NO TRANS
NO LAMPS
SERVICE O 600V 100
SERVICE OVER 600V 500
WIRING PERMIT loo
FIXTURE PERMIT too ^�
SUPPLEMENTARY PERMIT 50
TOTAL FEE APPROVALS
$ v DATE INSPECTOR S SIGNATURE
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP LIGATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING WIRING D r
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE POWER
DESCRIBED RESIDEN IALPR ERTY
SIGNATURE rw UTILITY CO NOTIFIED
OF PERMITTE 10, FINAL W970
JOHN A NGII V�,IDATION ARTHUR C VETT
COUNTY ENGINEER Mo CASH SUPERVISING ELECTRICAL ENGINEER
i
403790- OCT 28 2 785
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