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76A669-CE80610-50 APPLICATION FOR ELECTRIC PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT
ER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY ��✓LI 'r"
'-
FOR APPLICANT TO FILL IN NEAREST
PERMIT FEES CROSS ST.
OWNER -F�/I S r7
I T E M NUMBER I EACH FEE MAIL
OUTLET?
S ' ADDRESS F�
LIGHTS RECEPT. SW. .10 �' : - C
LIGHTING FIXTURES 10 CITY TEL.NO.
ELEC.RANGES CLO.DRYERS ELECTRICIAN - R a 6
r ( -�P
WATER HEATERS .50 ADDRESS/G.� 9/t�
ELEC.SPACE HTRS. DISHWASHERS / }
clrY c JZ i.:.` A L 1� TEL. No. G iGI ^� (`L(L•
GARBAGE DISPOSERS AUTO.-
WASHERS STA.COOKING UNITS .25 LICENSE NO. l CI
MOTORS: OVER INC. H.P. DISTRICTPG UP ZONE P E SED BY
0- 1/2 .25 9 LL.
1/2— z .50 —� INSPECTION RECORD
2- 5 1.00
5- 15 1.50
15- 50 2.50
50-200 5.00
NO.TRANS.
SIGNS:
NO.LAMPS
SERVICE 0-600V 1.00
SERVICE OVER 600V 5.00
MISC.
WIRING PERMIT 1.00
FIXTURE PERMIT 1.00 U
SUPPLEMENTARY PERMIT .50
TOTAL FEE S ,
IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ff
II, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT
ELECTRICAL WIRING.
I HEREBY CERTIFY THAT 1 AM 'PROPERLY REGISTERED AND/OR WIRING
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT i AM E LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PRO RT ^ POWER
SIGNATURE � 1 UTILITY CO.NOTIFIED
�
OF PERMITTEIV/1V
� FINAL
OF ✓ NIDATION ARTHUR C.VEIT,
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
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