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'6A663 CES0610 60 APPLICATION FOR ELECTRICAL PERMIT 1 1
COUNTY OF LOS ANGELES
DEPARMENT OF COUNTY ENGINEERBUILDING �+
BUILDING AND SAFETY DIVISION ADDRESS L J
JOHN A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY L
mi NEAREST
FOR APPLICANT TO FILL IN CROSS Sr r
PERMIT FEES OWNER
I T E M NUMBER EACH FEE MAIL +'e-� O /+
(O
OUTLETS f CITY
"Ts ADDRESS D� Cy
NCS
LIGHTS RECEPT / SW yEL ✓
NO
LIGHTING FIXTURES 10
t /s
ELEC RANGES CLO DRYERS ELECTRICIAN L 6t_
WATER HEATERS So 4ADDRESS L D
ELEC SPACE HTRS DISHWASHERS J/ lO
Pi EL NO C/ iJ
GARBAGE DISPOSERS AUTO
WASHERS STA COOKING UNITS 25 MOTORS OVER INC HP 919
O G Z N P CESSED BY
O— 1/2 25 L2�
1/2— 2 so INSPECTION RECORD
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2— 5a
too O
5— 15 150 V
a
15— 50 250 O
SO— 200 Boo ri
W
d
SIGNS NO TRANS N
NO LAMPS Z
SERVICE O 600V too 1106
SERVICE OVER 600V Boo
MISC
WIRING PERMIT 1 00
FIXTURE PERMIT 1 00
SUPPLEMENTARY PERMIT 50
TOTAL FEE $
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTORS SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT /y 1
ELECTRICAL WIRING WIRING 7 ��
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF TH ABOVE
DESCRIBED RESIDENTI ROPE TY POWER p
SIGNATURE UTILITY CO NOTIFIED JJ (t n
OF PERMITTE
FINAL 2VA I
IDATION AR C VETT "
c MO CASH
SUPERVISING ELECTRICAL ENGINEER
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