HomeMy Public PortalAbout9083 BROADWAY_Electrical__ 08969A 11-9D APPLICATION FOR ELECTRIC PERMIT g
DIVISION OF BUILDING AND SAFETY
Depmtmeat of County Engineer BUILDING
Cionaty Of Los Angeles ADDRESS 3
JOHN A. LAM BIE. COUNTY ENGINEER
CASSATT D. GRIFFIN. SUPT OF Bu ILDING LOCALITY f/
FOR APPLICANT TO FILL IN NEAREST
PERMIT FEES CROSS sr.
NUMBER _OWNER .�a '
LIGHT OUTLETS ("`CQS
MAIL
RECEPTACLES ADDRESS .Q,A�gw
WALL SWITCHES FEE CITY TEL. NO.
TOTAL OUTLETS @ 5¢ ' $ ELECTRI - IAN
ELEC. RANGES 25 ADDRESS Z.
ELEC. HEATERS 25
KW EA CITY TEL. NO. Wk
STATE
FIXTURES g LICENSE NO. J
MOTORS DISTRICT NO. G P E READT FOR INSPECTION
NUMBER HORSEPOWER FEE s I -� I
NEW MVO. HP OVER EACH
s4 B INC.C. s .25 _ INSPECTION RECORD
2 SD ('1 ) // F'rn���' G�� G/
2 ' S 1.00
_.A� `s�''/Dn TilJd,'l1//�%'� ,pi��s��+4i��
5 18 1.50 --Li!��ww 5C9'l� 1C.F'- '.�P1.'f. A✓V��
15 50 2.50
50 200 1 5.00
MISC.
D />I ral,d✓ �n�s
NO. SIGNS NO.TRANS. �.9
NO. SIGNS NO. LAMPS
FOR EACH PERMIT: aM-
WIRING $1.00
FIXTURES $,,00
SUPPLEMENTARY .50 APPROVALS
TOTAL FEE $ U DATE INSPECTORS SIGNATURE
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING
WIRING.
1 HEREBY CERTIFY THAT I A PRO ERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LO NG Cp$yJY AND STATE OF
CALIFORNIA OR THAT 1 AM E LE OVINER 0 B E POWER
DESCRIBED RESIDENTIAL P RTY,
SIGNATURE UTILITY CO.NOTIFIED
`
OF PERMITTEE FINAL
JOHN A.L.AMBIE.COUNTY ENGINEER VALIDA ARTHUR C.VETT.CHIEF ELECT. INSPECTOR
GK MO CABM
6 5,^ AUG 20 2 .0 13 if,