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7BA663 CES06 1,.,, APPLICATION FOR ELECTRIC PERMIT
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COUNTY OF LOS ANGELES �p
DEPARTMENT OF COUNTY ENGINEER BUILDING /� `� /i
BUILDING AND SAFETY DIVISION ADDRESS d-C,
JOHN A LAMBIE County Engmeer
CASSAIT D GRIFFIN Supt of Buildmg LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
PERMIT FEES ,
ITEM INUMBER EACH FEE OWNER
OUTLETS S g MAIL
LIGHTS RECEPT SW 10 ADDRESS
LIGHTING FIXTURES 10 CITY ,// TEL NO
ELEC RANGES CLO DRYERS ELECTRICIIAN �jZU_d_ Q ,
WATER HEATERS 50 ADDRESS v�y
ELEC SPACE HTRS DISHWASHERS /�,j. �// G
GARBAGE DISPOSERS AUTO CITY TEL NO 6 A%1
WASHERS STA COOKING UNITS 25 STATE �je `
LICENSE NO / L4 Gs V
MOTORS OVER INC H P
O — I/2 25
DIS RIC GR_ UP ZONE READY FOR INSPECTION
�—
I/2 — 2 50
INSPECTION RECORD
2 — 5 100
5 — 15 1 50
15 — 50 250
50— 200 5 00
SIGNS NO TRANS
NO LAMPS
SERVICE O 600V 100
SERVICE OVER 600V 500
MISC
WIRING PERMIT 1 00 0�
FIXTURE PERMIT 1 00
SUPPLEMENTARY PERMIT 50
TOTAL FEE APPROVAIS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE INSPECTOR SSIGNATURE I
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WRING WIRING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES !
LICENSED AS REpUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY POWER
SIGNATURE UTILITY CO NOTIFIED —l'��14 /
OF PERMITTEEFINAL D
ATION ARTA UR C VEIT`
SUPERVISING ELECTRICAL ENGINEER
CK MO CASH
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