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76A663-CE806 8-62 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A. JENSEN, SUPT OF BUILDING LOCALITY / I
NEAREST
FOR APPLICANT TO FILL IN CROSS
RECEPT. TOTALNO. JEACH FEE -
OUTLETS FIRST 20 $20 $ OWNER
LIGHT MAIL
ADD'L f0 ADDRESS
SWITCH. OVER 20
TOTAL CITY TE NO.
LIGHTING FIRST 20 .20
FIXTURES AD"L
oVgR 20 t 10 ELECTRICIAN
Y'
RANGES l CLO.DRYERS WTR.HTRS. 1.00 Q ADDRES Q ((�
GARB.DISP. STA.COOK CITY r l TEe. NO. O,(
DISHWASH. AUTO.-WASH. STATE
SPACE HTRS. BTA.APP.(Ys H.P.MAX.) .50
LICENSE NO.
MOTORS: OVER NOT OVER H.P. DISTRICT r. GROUP ZONE I P SSED�B/Y
O 1 1.00
1 3 1.50 INSPECTION RECORD
3 8 2.00
8 15 2.50
15 50 3.00 a
50 100 5.00 0
SIGNS: NO.TRANS C
NO.LAMPS Q
H
SERVICE 0.60OV•NOT OVER 200A 1.00 O 0 U
W
a
SERVICE 0.60OV•OVER 200 A. 2.00 t/)
SERVICE OVER 600V 5.00 Z
MISC. —
0
PERMIT ISSUING FEE 2.00
SUPPLEMENTAgY PERMIT ISSUING FEE 1.00
TOTAL FEE $ (Jd
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DAT! INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ry _.
ELECTRICAL WIRING. WIRING
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
'L-
ELECTRICAL
OR THAT 1 AM THE LEGAL�OR OF THE ABOVEDESCRIBED RESIDENT PE POWER SIGNATURE (//yQ�/R� i . UTILITY CO.NOTIFIEDOF PERMITTED '\ " '�f"�
FINAL
�LI ARTHUR C. VETT
CK MOO CAS CASH SUPERVISING ELECTRICAL ENGINEER