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76A668 CEBOS T eB APPLICATION FOR ELECTRIC PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE COUNTY ENGINEER
CASSATT D GRIFFIN SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PERM FEES CROSS ST
I T E M NUMBERI EACH FEE OWNER
OUTLET $ $ MAIL
LIGHTS RECEPT 6W O 10 ADDRESS
LIGHTING FIXTURES f0 CITY TEL NO
ELEC RANGES CLO DRYERS ELECTRICIAN
W A T E R H EATERS SO
ADDRESS
ELEC SPACE HTRB DISHWASHERS
-
GARBAGE DISPOSERS AUTO CITY TEL NO 00,
STATE
WASHERS STA COOKING UNITS 25 LICENSE NO 7
MOTORS OVER INC H P DISTRIC O GROUP ��D
O— 1/2 25 � �'J
1/2- z so INSPECTION RECORD
2— 5 too
5— is ISO—
is—
50is— 50 2 50
50-200 s 00
SIGNS NO TRANS
NO LAMPS
SERVICE O 600V 100
SERVICE OVER 600V 500
MISC
WIRING PERMIT 100 Q
FIXTURE PERMIT too Q
SUPPLEMENTARY PERMIT 50
TOTAL FEE $� G7 APPROVAIS
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 I ti`- ✓ L�
I 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 T W LEGAL OR OF THE ABOVE POWER
DESCRIBED RESIDENTIA OP Y J
SIGNATURE UTILITY CO NOTIFIED
OF PERMITTEE
FINAL
VALIMO CASH DATION AR H R C VEIT )
SUPERVISING ELECTRICAL NGINEER
C
1 2 3 8v9 DEC 22 2 A 3 2 0 M