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76A663 CES06 8/63 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE COUNTY ENGINEER .�
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY
NEA REST
FOR APPLICANT TO FILL IN CROSS ST
RECEPTTOTAL NO EACH FEE
WN
LISHT OUTLETS FIRST 20 $20 S MAIL
ADDDL10 ADDRESS
SWITCH OVER 20
TOTAL CITY TEL NO
LIGHTING 1 FIRST 20 20
1FIXTURES ADDL 10 ELECTRICIAN OVER 2O Li
r
RANGES CLO DRYERS WTR HTRB 1100 ADDRESS
GARB DISP STA COOK CITY TEL NO a /
DISHWASH AUTO WASH STATE
SPACE HTRB STA APP (Va H P MAX) 50 LICENSE NO O
MOTORS OVER NOT OVER HP DIS ICTO G52UP NE P ESSE BY
O , 100 / QAZ
1 s , so INSPECTION RECORD A n
S 8 200 l 6 (O
8 is 250
,5 6D 300
so 100 Boo 0 6
NO TRANS6.
SIGNS NO LAMPS Z
SERVICE O 600V NOT OVER 200A too
SERVICE O 600V OVER 200 A 1200
SERVICE OVER 600V 500
MISC
PERMIT ISSUING FEE 1200
=
SUPPLEMENTARY PERMIT ISSUING FEE too,
TOTAL FEE i
J
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTORES SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY y ~— t•
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT J
ELECTRICAL WIRING WIRING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY L08 ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNE OF THE ABOVE
DESCRIBED REBI PROPERTY POWER
SIGNATURE UTILITY CO
OF PERMITTE 9A. A I(_A ��
FINAL `7u /J6"'�✓J�
LIDATION ARTHUR C VEIT " it
CK MOS CASH SUPERVISING ELECTRICAL ENGINEER
AL 7 2 D 3.60- 1
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