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7BASA
DBS 8A It SS APPLICATION FOR ELECTRIC PERMIT 1
DMSION OF BUMDING AND Lj
FEY
Deportment of County engineBUILDING Z �j S r
Co=ty of Los Angeles ADDRESS
JOHN A LAMBIE COUNTY ENGr
CASSATT D GRIFFIN SUP T OF BUIOCALITY310
G
FOR APPLICANT TO FILL IN NEAREST
PER= FEES
NUMBER OWNER E
LIGHT OUTLETS MAIL v�
RECEPTACLES ADDRESS f V ✓
3 WALL SWITCHES FEE CITY Lr TEL NO T
TOTAL OUTLETS 0 Be $ ELECTRICIAN
ELEC RANGES 28
ADDRESS
ELEC HEATERS 25
KW EA CITY TEL NO
ATE
(FIXTURES s LICE SE NO
MOTORS DISTRICT O I GROUP I ZONE/I READY FOR INSPECTION
NUMBER HORSEPOWERJ �d1
FEE V
NEW I MVD HP OVER INC EACH
&LESS $ 25II�iSPECTION RECORD
14 2 so
2 S too
t
is Is ISO
Is SO 2 110
80 200 500
t
MISC
NO SIGNS NO TRANS
NO SIGNS NO LAMPS
FOR EACH PERMIT
WIRING $1 o0 GC
FIXTURES $100 CJ
SUPPLEMENTARY 50 APPROVALS
TOTAL FEE $ U DATE INSPECTOR S SIGNATURE
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT /
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING WIRING 3 SG. „�n
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES r
LICENSED AS REQUIREDBY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AN THE LEGAL OWNERF THE ABOVE POWER
DESCRIBED RESIDENTIAL PR ERTY
SIGNATURE UTILITY CO NOTIFIED
OF PERMITTEE FINAL
JOHN A LAMBIE COUNTY ENGINEER VMMA ARTHUR C VEIT CHIEF ELECT INSPECTOR
CK MO =H
1&5880�R JUN12 2 290