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7eAe83ici60e 9-qa APPLICATION POR ELECT CAL PERMIT
COUNTY OF LOB ANGELES
1 DEPARTMEN'1"%OF COUNTY ENGINEER ■u1LDING
BUILDING AND 8AF Y DIVSION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
COLISMAN W. JKNKINS, SUPERINTRNDKNT OF 19UILDING LOCALITY
NEAREST
FOR APPIKA TO FILL IN CROiS ST.
R[cEPT, TOTAL NO. EACH
Ounrn �y
LIGHT FIRST !O i.10 • OWfVtR G G
MAIL
SWITCH OVRlt ADD'L 10 ADDREM IS
i0
LIGHTING NG
1��
FIXTURM4 FIRST !O 20 v CITY
FIXTURn ,1O CONTRACTOR
OVVERER 10
1
RAMS[l DRYou WTR.MTIU. 1.00 ADD X" 477
OAIA,DIMP, STA.ODOK
N
DIMiwAIN, AUTO.•WABH. CITY
NATE
lPAC2 HTR/, PTA, AFFL. ASO LICENSE NO.
MOTORS, ovER NOT OVER N . DIST WCC r NK !' D BY
O 1 1.00 lJ
t a 7.80 INSPECTION RECORD
3 — 5 2.0.0
S 15 2,50
15 60 3,00 ( ,
50 100 111,000
SIGNS, NO.TRAM,.
Cie
NO.LAMPS
SIItVIC[0-e00V-NOT Dvot 200A 1.00
d
S[1tVIC[o.eoov-ova soo A. >y,00
SK"lex OVEIt eoov 5.00
OTHER (S[[ COMF'LETK FII SCH[DUL[)
PERMIT IMUING FIE 2.00
SUPPLXMKNTAJtY PXP MIT IMUING F2Z 1.00 DATE
rA.'D
OTAL FQQ
y ACKNOWL[OQR THAT I HAV[READ THIK APPLICATION L)NDtRSLA5 WORK
TE THAT THE MOVE Il CORRECT AND AOMM TO COMPLY ROUGH CONDUIT
L COUNTY ORDINANCE• AND STATE LAW/ REGULATINQ
ICAL WIRING. WIRING
EIY CERTIFY THAT I AM IIROrOtLY REQIITXjUM AND/OAF17(TUR][SD Al REQUIRED ■Y LQ■ANG[LEl COUNTY AND STATE OFNIA OR THAT I AM TH[ LKQAL OWNSA OF, AND INTEND TOIN,TH[ [ICAISED ftl: ENTIAL PROP"MY
URE ] UTILITY NOTIFIIIITTE
FINAL
�ac U JOSEPHSI ROOHAN
Yo CASH SurvitV1SING
ELECTRICAL tllGlNtpt
eS � Of-- X16 2 D 2.80Ncc