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TeAeee ceeoe . ee APPLICATION FOR ELECTRICALERMI
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY NO
BUILDING AND SAFETY DIVISIONER ADDREISG D 7e-,MM jPR
JOHN A LAMBIE COUNTY ENGINEER /1 �J
COLEMAN W JENKINS SUPT OP BUILDING LOCALITY G /
NEAREST
A CROSS ST
RECEPTA TOTAL No EACH F[[
GL1TLErE FIRST IIO S 20 S OWNER
L16HT `
SWITCH
OVER 2 10 woo KESS p�
TOTAL FIRST 20 IIO CITY TEL NO
LIGHTING FIXTU REB ) C
PI%TURED ADD 10 CONTRACTOR Cif L.
OVER 20
RANGES CLO DANKAS WTR HTRS 100 'ADDRESS
GARB DISP STA COOK C TEL NO
CITY
DISHWASH A1110 WARN STATE
SPACE HTRE STA APF (V.M P MAX 1 50 LICENSE NO
MOTORS. ovu NOT OVER MP DI/��Q�CT GRO P Z NE
O 1 100
��—// Q
1 — a ISO INSPECTION RECOOD
2 — B 200
a — is ---zoo
IS — SO 300 O
U
60 100 Soo
01
SIGNS, NO TRANS O
NO LAMPS 1{rLJ
SERVICE O SOOV NOT OVER SODA 100 d
N
SERVICE O 600V OVER 200 A 200 - Z
SERVICE OVER SOOV Soo
OTHER (SEE COMPLETE PEE SCHEDULE)
PERMIT ISSUING FEE 200 Q
SUPPLEMENTARY PERMIT ISSUING FEE 1 00
TOTAL PEE 0 (JfJAPPROVAL111 DAT[
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION UNDERSLAB WORK
AND STAT[THAT THEABOVE 10 CORRECT AND AGR[[ TO COMPLY ROUGH CONDUIT V
WITH ALL COUNTY 0RDINANCEa AND STATE LAWS REGULATING '
ELECTRICAL WIRING WIRING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LI C[NS[D AS REQUIRED by LOS A OELES COUNTY AND STATE OF _
CALIFORNIA OR THAT I AM THE AL OWNER AND INTE TO POWER
RESIDE IN THE Ap [pC R[SID NTI ROP[RTY
SIONATU RE UTILITYCO NOTIFIED
OF PERMITTE
FINAL
0 LIDATION JOSEPH C ROOHAN
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
LAAO 1 1 2 7-� APR 11 2 D 9.0