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76AG63_CESOO-9_S7 APPLICATION LICATION FOR ELECTRIC PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING y
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE,COUNTY ENGINEER �+
CASSATT D GRIFFIN,SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
PERMIT FEESJv OWNER �HQ,�L
ITEM NUMBE EACH FEE
OUTLET I7 S S MAIL
LIGHTS RECEPT SW ,AC 10 ADDRESS
LIGHTING FIXTURES f0 CITY TEL NO
ELEC RANGES CLO DRYERS ELECTRICIAN '
WATER HEATERS 50 ADDRESS �O
ELEC SPACE HTRS DISHWASHERS /� `
GARBAGE DISPOSERS AUTO- CITY a L��7/J TEL N0
WASHERS STA COOKING UNITS 25 STATE
LICENSE NO /' v
MOTORS OVER INC H P ommmmummmm
DISTRICT NO GR/J ZONE READY FOR INSPECTION
1/2 — 2 50
INSPECTION RECORD
2 — 5 100
5 — 15 150
15 — 50 250
50— 200 500
SIGNS NO TRANS
NO LAMPS
SERVICE 0-600V 100
SERVICE OVER 600V 500
MISC
WIRING PERMIT 100 �J,a
FIXTURE PERMIT too
SUPPLEMENTARY PERMIT 50
TOTAL FEE $ APPROVALS
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE INSPECTOR SS SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING -
ELECTRICAL WIRING /�''� WIRING ! J
1 HEREBY CERTIFY THAT I AM P LY(?" REGIS AND/OR
LICENSED AS REQUIRED BY LOS NTY STATE OF FIXTURES _
CALIFORNIA OR THAT 1 AM THE ABOVE
DESCRIBED RESIDENTIAL POWER
SIGNATURE UTILITYCO NOTIFIED
OF PERMITTE
FINAL
VALIDATION ARTHUR C VEIT.
SUPERVISING ELECTRICAL ENGINEER
CK MO CASH
LO,lt 8' 3'N .fid_ 7 2 A 6.00