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76A669 CE6061059 APPLICATION FOR ELECTRI PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEERBUILDING
BUILDING AND SAFETY DIVISION ADDRESS ' a&dd�14 ,Lt
JOHN A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN CROSS 7 t�µ11�L
PERM FEES
1 T fi M NUMBER I EACH FEE OWNER
MAIL
OUTLET $ 10 $ ADDRESS
LIGHTS RECEPT SW
LIGHTING FIXTURES 10 v-Q CITY TEL NO
ELEC RANGES CLO DRYERS ELECTRICIAN
WATER HEATERS 50 ADDRESS
ELEC SPACE HTRS DISHWASHERS CITYTEL NO
GARBAGE DISPOSERS AUTO STATE v
G�/J /
WASHERS STA COOKING UNITS 25 LICENSE NO /(/
MOTORS OVER INC H P DIST T N I GROI�P ZON PROCESS ABY
O— 1/z 2 5
150
1/2— 2 50 INSPECTION RECORD
$— 15 ISO � � /J-
i
is— 50 250
50-200 500
SIGNS �yN�O TRANS
YO LAMPS
SERVICE O 600V 100
SERVICE OVER 600V 500
MISC
WIRING PERMIT 100
FIXTURE PERMIT too Q-d
SUPPLEMENTARY PERMIT 50
TOTAL FEE t,3 -LE)
IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT t
ELECTRICAL WIRING WIRING .,�� 1@
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES J
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY POWER
SIGNATURE UTILITYCO NOTIFIED
OF PERMITTE ^
FINAL 1 _�
OF /I–A-IdDATION ARTHUR C VEIT
MO GASH SUPERVISING ELECTRICAL ENGINEER
CK
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