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76A663 CE80b B 62 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING '
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE COUNTY ENGINEER r
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY
NEAREST /JJ B �_
FOR APPLICANT TO FILL IN cRoss ST
RECEPT ,J TOTAL NO EACH FEE /JI� /I
OUTLETS FIRST 20 /fl $20 $ oo OWNER �/ (//�t�•T�
LIGHT VV MAIL
SWITCH ^ ADD L 10 ADDRESS
0. O OVER 20
F7Rsr 20 20
TOTAL Go CITY TEL NO
LIGHTING
FIXTURES 3 ADD L OVFR 20 1
10 ELECTRICIAN
RANGES CLO DRYERS WTR HTR9 1100 ADDRESS J ,J nif_ C
All
GARB DISP I STA COOK Tr I CITY TEL NO / p 3
IaHWAa 1 A ^ STATE
SPACE HTRS STA APP (l/a H P MAX ) 50 004" SA LICENSE NO -G/O
i
MOTORS OVER NOT OVER HP DISTRICT NO GROUP ZONE P73D BY
el�l0 1 ! 100 00L
1 3 150 , INSPECTION RECORD
3 8 200
8 15 250 ,
15 SO 300
50 100 Soo
SIGNS NO TRANS ' 0:
NO LAMPS O
H
SERVICE O 600V NOT OVER 200A / loo /jay W
SERVICE O 600V OVER 200 A 200 N
SERVICE OVER 600V 500 ?
MISC
PERMIT ISSUING FEE 200 Q(J
SUPPLEMENTARY PERMIT ISSUING FEE 100
TOTAL FEE 6
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR S SIGNATURE
AND STATE THAT THE ABOVE 1S CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ) y
ELECTRICAL WIRING WIRING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR IIS
LICENSED AS REQUIRED BY LOB ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY POWER / v
OF PERMITTEE-v r UTILITY CO NOTIFIED
FINAL
VALARTHUR C VEIT
MO
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
,0 0 0 9- SEP 11 2 D 9.1 ()— q