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76A663 CE806 9 64 APPLICATION FOR ELECTRICAL PERMI
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING /�
BUILDING AND SAFETY DIVISION ADDRESS IVss RO
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUP T OF BUILDING LOCALITY
NEAREST \ ( _
t/ FOR APPLICANT TO FILL IN CROSS ST LJST
RECEPT 4 1 TOTAL NO EACH FEE r :soOUTLETS FIRST 20 � $20 $ OWNER /L
NFE
LIGHT I MAIL
ADD L ADDRESS S Z �-E N D
SWITCH 1 OVER 20 10 ^1�
LIGHTING TOTAL FIRST 201 20 CITY 1 - TEL NO T
FIXTURES } ADO L Io ELECTRICIAN F --NS"T LL
OV R 20
RANGES CLO DRYERS WTR HTRS 100 ADDRESS lolz�a p p R V C
STA COOK CITY T5 TEL NO
ISH WASH A4F WASH" _� ^ O j\ STATE
SPACE HTRS A APP (1/s H P MAX ) G 50 v LICENSE NO
MOTORS OVER NOT OVER HP DIST CT GROUP NE P CESSED B
r
O 1 100
1 3 150 INSPECTION RECORD
3 8 200 !d ��/ ��f"�L �� O
8 15 250 G V
15 50 300 Q
F
50 100 500 V
w
D_
NO TRANS
NO LAMPS N
SIGNS
Z
SERVICE O 600V NOT OVER 200A 100
SERVICE O 600V OVER 200 A 1200
SERVICE OVER 600V Soo
MISC
PERMIT ISSUING FEE 200 L
SUPPLEMENTARY PERMIT ISSUING FEE 100
TOTAL FEE $ 4 Q
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 CONDUIT
/ �/9/'1`�
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING WIRING
q V
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES 1 �V
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OFAND INTEND TO
RESIDE IN THE ABOSIGNATUR :Rc�
RESIDENTIAL PROPERTY POWER
OF PERMITTEE 3. UTILITY CO NOTIFIED } _
FINAL
LIDATION JOSEPH ROO
C
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
j" 6928\ OCT29 2,1D 4.40- q