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,GAGGS CESOS ,o so APPLICATION FOR ELECTRIC PERMIT
BUILDING AND SAFETY DIVISION `
Department of County Engineer BUILDING /®/C J r �jGr
County of Los Angeles ADDRESS (��/�G Y�r
JOHN A LAMBIE COUNTY ENGINEER
CASSATT D GRIFFIN SUP T OF BUILDING LOCALITYJ67
72� v
NEAREST 1
FOR APPLICANT TO FILL IN CROSS
PEMMT FEES d
/�'/
v OWNER
LIGHTS RECEPTACLES SWITCHES MAIL /(O ///L•! C
NUMBER ITEM EACH FEE ADDRESS ( (,a/YC�J �G
TOTAL OUTLETS $ 10 S
ELEC RANGES WATER HEATERS CITY C G C,& TEL NO ArZ6
CLOTHES DRYERS s0 ELECTRICIAN
ELEC SPACE HEATERS STAT Y COOK
ING UNITS GARBAGE DISPOSERS ADDRESS
AUTO WASHERS DISHWASHER 25
LIGHTING FIXTURES 10 CITY TEL NO
MOTORSSTATE
LICENSE NO
HORSEPOWER
HP OVER INC DISTRICT NO GROUP ZONE READY FOR INSPECTION
Va 8 LESS 2s
- 2 5o INSPECTION RECORD
2 — S 100 r
All
5 — 15 1 50 A' '�
OF
1s — 50 250 W1�1 Ca
50 — 200 500
I
MISC 7
K 19,
1
SIGNS I NO TRANS
NO LAMPS 1
SERVICE O 500V 100
ti
SERVICE OVER 600V 5_q0
WIRING PERMIT 1020 O
FIXTURE PERMIT 10.0 11
SUPPLEMENTARY PERMIT 50 APPROVALS
TOTAL FEE S ` DATE INSPECTOR S SIGNATURE
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APIFLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT f
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING WIRING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER THE ABOVE POWER
DESCRIBED RESIDENTIAL PROP TY
SIGNATURE i ) UTILITY CO NOTIFIED
OF PERMITTEE
FINAL
IOHN A LAMBIE VALIDA(✓' ARTHUT2 C VEIT�
.OUNTY ENGINEER SUPERVISING ELECTRICAL ENGINEER
CK MO SH
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