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7EAee1{EGOe-If-CfAPPLICATION FOR ELECTRIC PERMIT 1
COUNtY OP LOS xNamm
DFpARnOW OF COMM E'(GnMM BUILDING 1 -
BDS.DDPG AND SAFEff DMMON ADDRESS 7
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NEAREST
FOR APERMNTFILL IN a
IT[r NUMBER EACH PEs OWNER
OUTLs f MAIL
LIGHTS ffcxpT 4r eW to ADDRESS
LIGHTING FIXTURES 10 CI EL N
ELEG RANG" cLo 0RYERD AN
WATER HEATERS KID D RESS-5
ELEC SPACEHTRS DIEHWNH<tU
OAREAGE 019PO ERS AUTO- I CITY Tm. N
WASHERS STA COOKING UNITE 20 STATE
LICENSE NO
MOTORS OVER IN H
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V. — 2 SO
2 — S loo ON HECOHD
D — IS ISO Ato
ID — SO 250
SO— 200 500
SIGNS NO TRANS
No LAN"
SERVICED SOOV 100
SERVICE OVER SOOV Soo
MISC
WIRING PERMIT Igo
PIXTU RE PER MIT 100_
SUPPLEMENTARY PERMIT So d
TOTAL FEE 1 f AMOMS
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE INSPECTOR SSI NATURE
AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING WIRING
1 HEREBY CERTIFY THAT I AN PROPERLY REGISTERED AMD/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 RESIDENTIAL PROPERTY
SIGNATURE UTILITY CO NOTIFIED
OF PERM]TYKE
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