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7GA668 CE806460 APPLICATI®N F R ELECTRI L PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING 15—:
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE, COUNTY ENGINEER 1
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
PERMIT FEES OWNER a AJ Or
1 T E M INUMBER EACH FEE MAIL
OUTLET S ADDRESS M
LIGHTS RECEPT SW 10 J1
LIGHTING FIXTURES 10 a CITY TEL NO
ELEC RANGES CLO DRYERS ELECTRICIAN "�` !�.��t- ���-
/� tA u L—:—
WATER HEATER 8 SO ADDRESS A" l /
ELEC SPACE HTRS DISHWASHERS CITY,5 M .l_1 TEL NO I G
GARBAGE DISPOSERS AUTO STATE
LICENSE NO
WASHERS STA COOKING UNITE 25
MOTORS OVER INC H P DISC R1 T NO =P NE I P CESSE BY
0 — 1/2 25 ~8 // 6
C/
,i, — 2 sp INSPECTION RECORD
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2 s 100 .tee e • o-
s — 1s I so A( �6d�a %'� �1 � O
15 50 250 , I �'J s¢�.a� 0
50 — 200 goo w� U
W
NO TRANS O.
SIGNS N
NO LAMPS Z
SERVICE O 600V 1 00 D
SERVICE OVER 600V Boo
MISC
WIRING PERMIT too O Z)
FIXTURE PERMIT 100 G
SUPPLEMENTARY PERMIT s0
TOTAL FEE
1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALLCOUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT +
ELECTRICAL WIRING WIRING ,rl¢e
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES A `R
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE ! /
DESCRIBED RESIDENTIAL PROPERTY POWER
SIGNATURE UTILITY CO NOTIFIED I /7_✓%/�
OF PERMITTE FINA 1,91 .�
A IDATION ART14URC VEIT' I
SUPERVISING ELECTRICAL ENGINEER
CK MO CASH
LAt�,'o 2 01 0 AUG 3 2 D 8 4 0
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