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4A663 CE806 B-62 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING '`
BUILDING AND SAFETY DIVISION ADDRESS /7 l
JOHN A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY �� f
NEAREST /)
FOR APPLICANT TO FILL IN CROSS ST (/
RECEPT ' TOTAL NO EACH FEE
/� OUTLE FIRST 20 $20 $ D OWNER
LIGHT
ADD L IO ADDRESS
SWITCH
OVER 20
LIGHTING TOTAL F1RST'�O 31 20 6 a CITY ��/ TEL NO y
FIXTURES ADD L 1O ELECTRICIANW/-OJ p 6Z �/� (e
OVFR 20
RANGES CLO DRYERS WTR HTR 100 ADDRESS
GARB DISP STA COOK
CITY TEL NO
DISHWASH AUTO WASH STATE
SPACE HTRS '"SFA APP ('/.HP MAX) 50 LICENSE NO
MOTORS OVER NOT OVER HIP", DISTRICT N GR Z P O B
too �p
1 3 ISO INSPECTION RECORD
3 S 200
8 15 250
15 50 300
SO 100 500 0
SIGNS NO TRANS
NO LAMPS C
O
SERVICE O 600V NOT OVER 200A 100
SERVICE O 600V OVER 200 A 200 N
SERVICE OVER 600V 500 ?
MISC
PERMIT ISSUING FEE 1200
SUPPLEMENTARY PERMIT ISSUING FEE 100
TOTAL FEE $ Q
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS ATE INSPECTOR S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT 12,9
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING /
ELECTRICAL WIRING WIRING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM THE LEGAL OWNER O THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY CCC POWERof
/ /J
SIGNATURE UTILITY CO NOTIFIED
OF PERMITTEE I FINAL / b>
/V-ALIDATION ARTHUR C VEIT
CK O CASH SUPERVISING ELECTRICAL ENGINEER
ijtLo 9 3 3"-D JAN 9 2 D 6 40- �l