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7GA663 CESOB 6 57 ,APPLICATION FOR ELECTRIC PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUELDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE COUNTY ENGINEER _ Iry�.,
CASSATT D GRIFFIN SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN CROSS ST L//via a
PERMIT FEES
OWNER
LIGHTS RECEPTACL S SWITCHES
NUMBER I T E M EACH PEE MAIL
ADDRESS L ()
TOTAL OUTLETS f 10
A 7Z ELEC RANGES WATER HEATERS CITY TEL NO L3 n
03
CLOTHES DRYERS -§ 5o ELECTRICIAN '
ELEC SPACE HEATERS STAT Y COOK
INUNITS GARBAGE DISPOSERS F ADDRESS
_AU TO WASHERS DISHWASHER 25
LIGHTING FIXTURES 10 CITY TEL NO
MOTORS L CENSE NO
STATE
HORSEPOWER
H P OVER INC DISTRICT NO [GROUP ZONE READY FOR INSPECTION
%@ LESS 25
'/2 - 2 5o INSPECTION RECORD
2 — 5 Too
5 — 15 1 50
~y 15 — 50 250
50 — 200 5 O0
F � '
c
MISC
1
SIGNSI NO TRANS
NO LAMPS
SERVICE O 600V 100
SERVICE OVER 600V 5 00
WIRING PERMIT 1 pp Y
FIXTURE PERMIT 100
r
SUPPLEMENTARY PERMIT 50 rr APPROVALS
TOTAL FEE $
s DATE INSPECTOR S SIGNATURE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLIffATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING WIRING
t I HEREBY CERTIFY THAT 1 AM PROPERL REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LQS ANGELES UNTY AND STATE OF
CALIFORNIA OR-THAT 1 AM THEL L NER OF THE ABOVE POWER �
DESCRIBED RESIDENTIAL PROPERTY _
SIGNATURE 1 UTILITY COt NOTIFIED
OF-PERMI TEF ti
FINAL
JOHN A LAMBIE r VALIDATION ARTHUR C VEIT
COUNTY ENGINEER MO CASH SUPERVISING ELECTRICAL ENGINEER ti
/CIQ�