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7GA663 CEBO6 10 60 APPLICATION FOR ELECTRICAL PERMIT 1
COUNTY OF LOS ANGELES
DEPARMENT OF COUNTY ENGINEER BUILDING a
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY c
NEAREST r /
FOR APPLICANT TO FILL IN CROSS ST
PERMIT FEES OWNER
I T E M NUMBERI EACH FEE MAIL
OUTLET ADDRESS
LIGHTS RECEPT SW (I 10 CITY TEL NO
LIGHTING FIXTURES 10
ELEC RANGES CLO DRYERS ELECTRICIAN 9 /LCC
W A T E R HEATERS 50 ADDRESS /J1 9p(
ELEC SPACE HTRS DISHWASHERS
CITY TEL NO A 21
GARBAGE DISPOSERS AUTO STATE
WASHERS STA COOKING UNITS 1 25 LICENSE NO O
MOTORS OVER INC H P DISTRIC ( G�P NE PR ESSED BY
O— 1/2 25 (J
1/2— 2 so INSPECTION RECORD
2— 5 100 d
5— 15 150 0
is— 50 250
ce
SO— 200 500 0
1--
NO TRANS W
SIGNS NO LAMPS } N
SERVICE O 600V 100 1
SERVICE OVER 600V Soo
M ISC
WIRING PERMIT 1 00 n0
FIXTURE PERMIT 100 CjtJ
SUPPLEMENTARY PERMIT 50
TOTAL FEE $ 3
1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTORS SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT
ELECTRICAL WIRING WIRING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR nn
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES 1 11
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE \ 1
DESCRIBED RESIDENTIAL PROPE POWER 4 p� p
SIGNATURE UTILITY CO NOTIFIED .A-1 11 f � NM fill
OF PERMITTEE FINAL
LIDATION ARTHUR C VEIT
CK Mo CASH SUPERVISING ELECTRICAL ENGINEER
�E4C- D � o __4 -7L"26 2 D 330 n