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76AS610ES" 8.82 APPLICATION' FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS y
JOHN A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN, SUP T OF BUILDING LOCALITY ,
NRSSST
I CRSS ST
PP ,.
nECEFT TOTAL No urJH
OUTLETS FIRST 20 /� Y0 0 OWNER
LIGHT V MAIL
WITCH AGG'L
S10 O ADDRESS
OAD L
LIGHTING TOTAL Fl RST 20 20 O CITY TEL NO
FIXTURES A R 2 10 ELECTRICIAN
OV A 2041
RANGES OLD DRY s WTR HTRS 100 ADDRESS
am" DISP ETA COOK CITY � TEL No G/
Dle"wAeN wUTo WASH STATE
YALE HTRS STA MP 141 H P MAX ) a0 LICENSE NO
MOTORS, OVER NOT OVER H P ___j_DI T ICT N iGarpl P E D "
o 1 Io0
1 s 150 INSPECTION R CORD
a 6 200
e
is it to
is ao Soo
a
so Ioo Soo O
V
SIGNS, NO TUNS a
NO LAWS
O`~
SERVICE O 600V NOT oven 200A 100 tL7
SERVICE O OOOV OVER 200 A 200 a
N
SERVICE OVER a00V 600 Z
MISc
PERMIT ISSUING FEE 200
SUPPLEMENTARY PERMIT ISSUING FEQ 100
TOTAL FEE 0O
I HeR®Y ACHNOWLED" THAT I HAvc READ THIS AlLfCAT..N7
APPROVALSMn M o •a u
AND STATE THAT THE ABOVE IS CORRECT AND AGIRE TO COMPLY
WITH ALL COUNTY ORDINANCE[ AND RATE LAWS REGULATING
EI.ERRIGL WIRING
1 HenESY C<RTIPY THAT 1 AM PRORRLY REOISTE AMDf W
ucEN® AS REQUIRED Sr LOS AN
COUNTY AND STATE OP
uurORNIw oR THAT I IW THE LEGAL OWNER OP THE ABOVE
DEICRHIED RESIDENTIAL PROPERTY
SIGNATURE
OF PERMITTE
i
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IDATION ARTHUR c vEITNJ
CK NO CASH SUPERVISING ELECTRICAL ENGINEER
�;,� 2 7 1 5 Q NOV 19 2 D 920- !7