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78A66C Ch#'SOB 5 61
APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY
NEAREST
f FOR APPLICANT TO FILL IN CROSS ST
PERMIT FEES OWNERo IL
e
1 T E M NUMBER EACH I FEE MAIL
OUTLET ADDRESS
S S
LIGHTS RECEPT SW 1C 44
CITY TEL NO
LIGHTING FIXTURES 10 ion
ELEC RANGES CLO DRYERS ELECTRICRWHAADSbb WAMT[a to.,,
WATER HEATERS 50 ADDRESS
ELEC SPACE HTRS DISHWASHERS
CITY TEhi V
a
GARBAGE DISPOSER$ AUTO Lo
gTATE
WASHERS STA COOKING UNITS 2$ LICENSE NO
MOTO S OVER INC H P cv DISTRICT O GROUP I ZONE PROCESSED BY
OF 1/2 2$
1/2— z W3 so INSPECTION RECO- RDVr-
2— 5 100
5— 150 v
Is— so 250 m
SO— 200 $oo V
SIGNS NO TRANS d
NO LAMPS Z
SERVICE O 600V 100 1 160
SERVICE OVER 600V 500
M ISC
WIRING PERMIT too
FIXTURE PERMIT 1 00
SUPPLEMENTARY PERMIT 50
TOTAL FEE g
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLrATION APPROVALS DATE INSPECTOR S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE T M
WITH ALL COUNTY ORDINANCES AND STATE L O N CONDUIT / n AA
ELECTRICAL WIRING WIRING
1 HEREBY CERTIFY THA 1 OS NGELE L G D ND R
LICENSED AS REQUIRED Y LOS ANGELE D AT OF FIXTURES
CALIFORNIA O HAT I TH LEG F E OVE
DESCRIBED RE ID NTIAL OPERT POWER )/� � /
SIGNATURE
OF PERM ITTUTILITY CO NOTIFIED )� •L
E
FINAL G�
IDATION ARTHUR C VEIT
L.; Mo CASH SUPERVISING ELECTRICAL ENGINEER