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76A663 CE806 It 57 APPLICATION FOR ELECTRIC PERMIT 1'
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER B U I L D I N G /^
BUILDING AND SAFETY DIVISION ADDRESS y�f�a"�J Law j c (,ink
CASSATTOHN AD GRIFFIN Supt. Buil Engineer
P �g LOCALITY G
NEAREST
FOR APPLICANT TO FILL IN CROSS ST �v
PERNIIT FEES
ITEM NUMBER EACH FEE
OWNER
FELECSPACEHTRS
g g , y� MAIL IT
RECEPT SW
10 f/ ADDRESS
FIXTURES 10 CITY T TEL NO
S CLO DRYERS ELECTRIC,.I/A
ER HEATERS 50 ADDRESS
HTR3 D19HWASHERS POSERS AUTO CITY TEL NOSTA COOKING UNITS 25 STATE t�
MOTORS OVER INC H P LICENSE NO
DISTRICT GRO ZONE READY FOR INSPECTION
o — t/2 25
I/2 - 2 50
2 - 5 100
INSPECTION RECORD
5 - 15 1 50
15 - 50 250
50- 200 500
SIGNS NO TRANS
NO LAMPS
SERVICE O 600V 100
SERVICE OVER 600V 500
MISC
WIRING PERMIT 1 00
FIXTURE PERMIT 1 00 p�
SUPPLEMENTARY PERMIT 50
TOTAL FEE g gD APPROVALS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE INSPECTOR S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING WIRING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE POWER
DESCRIBED RESIDENTIAL ROPERTY
SIGNATURE UTILITY CO NOTIFIED
OF PERMITT �L
FINAL
LIDATIO� ARTH URVETT
CASH SUPERVISING
G ELECTRICAL ENGi EER '
CK MO
;p.2 4 100; FES 13 2 A 2-90
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