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16A666 CES06460 APPLICATION FOR ELECTRICAL PERMIT �
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER rAADD=RESS
BUILDING AND SAFETY DIVISION JOHN A LAMBIE COUNTY ENGINEERWILLIAM A JENSEN SUP T OF BUILDING ALITY �� C l T
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
PERMIT FEES OWNER /g S
1 TEM INUM19ER EACH FEE MAIL
OUTLETS $ $ ADDRESS
LIGHTS RECEPY;;�;e SW 10
LIGHTING FIXTURES 10 CITY T
ELEC RANGES CLO DRYERS ELECTRICIAN
W A T E R H EATERS 50 ADD SS / �+r7
ELEC SPACE HTRS DISHWASHERS CI TEL NO C Y
GARBAGE DISPOSERS AUTO STATE /
WASHERS STA COOKING UNITS 25 LICENSE NO 7 !v
MOTORS OVER INC H P DISTR�f NO I GROUP ZONE P CESSED BY
O — %2 25
,1/, — 2 so INSPECTION RECORD
2 — 5 too fo (a/ _ �O J1 1 a
5 — Is 150 O
15 — SO 250 w
O
50 — 200 500 ~
U
W
SIGNS NO TRANS N
NO LAMPS Z
SERVICE O 600V loo O�U
SERVICE OVER 600V 500
MISC
WIRING PERMIT 1 00
FIXTURE PERMIT 100
SUPPLEMENTARY PERMIT 80 �yC
TOTAL FEE $
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY A
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT
ELECTRICAL WIRING WIRING
I HEREBY CER T i AM P PE EGISTERED AND/OR
LICENSED AS QUI BY LOS A NTY AND STATE OF FIXTURES
CALIFORNIA,OR TH AM THE G ER OF THE ABOVE f
DESCRIBED REBID IP ER POWER
SIGNATUR � UTILITY CO NOTIFIED
OF PERM] �((���� ✓(O
FINAL
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LIDATION ARTHURC VEIT
cK MO CASH SUPERVISING ELECTRICAL ENGINEER
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