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76A663-CE806 B-62 APPLICATION FOR ELECTRICAL PER
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING 2
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY /—,
NEAREST --TT
FOR APPLICANT TO FILL IN CROSS ST
TOTAL NO EACH FEE
RECEPT J,j
/ � OUTLETS FIRST 20 Q Is 20 $ O MA NER
LIGHT / ��
ADDL ADDRESS
SWITCH OVER 20 10 7v
TOTAL CITY TEL NO
LIGHTING FIRST 2O 20 Q
FIXTURES IADD L 10 ELECTRICIAN f/JY1 D OVPR 20
RANGER O DRYERS WTR HTRS 1 OD /F 00 ADDRESS -2
GARBDISP STA COOK CITY TEL NO V
DISHWASH AUTO WASH STATEJ
SPACE HTRS STA APP (yz H P MAX 50 1 D D LICENSE NO 9 7 0 8
MOTORS OVER NOT OVER HP DISTRICT NO GROUP Z NE PRO SSED BY
loo �` y �r
1 s 150 1 INSPECTION RECORD
s 8 200 g wl-
1
8 1S 250 l f
15 50 300 A '
50 100 500 A% �q� �t //� u
SIGNS NO TRANS 9 K ®�NO LAMPS t� �� S ,fj �'�„p�{y� ` O
SERVICE O 600V NOT OVER 200A 1100 aj�ifC�i ��^/� �����rrrr�j;¢( A
�.w/ u�. �iR'Ar�tl��d M+'H' r 1 W
SERVICE O 600V OVER 200 A 2 00 f h
SERVICE OVER 600V 500 / ?
MISC
PERMIT ISSUING FEE 200 Dv
SUPPLEMENTAgY PERMIT ISSUING FEE 1100
TOTAL FEE $
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR 8 SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING A/
ELECTRICAL WIRING WIRING Ag
1HEREBY CERTIFY THAT I AM ROPERLY REGISTERED AND/OR i
LICENSED AS REQUIRED BY GELES C Y AND STATE OF FIXTURES
CALIFORNIA OR THAT I LEG O NE OF ABOV F` yr-
DESCRIBED RESIDENTIA RD r POWER e
SIGNATURE UTILITY CO NOTIFIED ®�1
OF PERMITTEE Ar
FINAL vs+
�LIDATION ARTHUR C VEIT
C MO CASH SUPERVISING ELECTRICAL ENGINEER
��l,o 5 8 0 6 FEB 21 2 D 1 7 10—