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76A663-CE806 8-62 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES - -
DEPARTMENT OF COUNTY ENGNEER BUILDING
BUILDING AND SAFETY DIVISION AO DRESS 9663 Broadway
JOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A. JENSEN, SUPT OF BUILo1RG LOCALITY Temple City
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
RECEPT. TOTAL NO. EACH FEE
o UTLETs FIRST 20 115
I $.20 S OWNER Bezaire
LIGHT 1: i OO MAIL
IIITr ADD'L f0 ADDRESS
SWITCH. 6 DYER 20
GHTING
LITOTAL FIRST 201 .20 $Q`L
CITY TEL. NO.
I
FXTURES } L I OVER
.10 ELECTRICIAN - R.L. Conlee Electric
OVVR
RANGES OLO.DRYERS WTT�R.HTR.. 11.00 ADDRESS 1030 N. Grandview Ave.
GARB.CHIP. _ STA.COOK p 'azl CITg San GabrielTEL. No. At.0-2007
DISHWASH. AUTO.-WASH. STATE
5C I SPACE HTRS. I STA.APP.('/s H.P.MAX.) 1 .50 LICENSE NO. 117K67
MOTORS: OVER NOT OVER H.P. DISTRICT O. GROUP NE PR E BY
0 1 1.00
1 s 1.50 INSPECTION RECORD
3 8 2.00
B IS 2.501
15 50 3.001 +�
50 100 5.001 1 0
SIGNS: NO.TRANS
NO.LAMPS
Q
SERVICE O.60OV-NOT OVER 200A 1.001 W
SERVICE 0.60OV.OVER 200 A. 12.00 1
N
SERVICE OVER 600V 15.00 ?
MISC.
r�I
PERMIT ISSUING FEE 2G.00 O
SUPPLEMENTARY PERMIT ISSUING FEE1.00 EL
TOTAL FEE
IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY _ CONDUIT 1. OrP/
WITH ALL COUNTY OROINANC.. AND STATE LAWS REGULATING O
ELECTRICAL WIRING. WIRING {' � �-
.T
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR 1
LICENSED A9 REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE i
DESCRIBED RES IOENTIALFROPERTY. Q POWER
SIGNATUREagl
UTILITY CO.NOTIFIED
OF PERMEE o�i J
ITTrt ,yf 1��f<_'H' P°fJ"Yn.fAM�I
FINAL
U(/NIDATION ARTHUR C. VEIT '
r CK/ MO CASH SUPERVISING ELECTRICAL ENGINEER
u0004t-SEP11 2.'D 6.80 q
16A663-CE806 5-62 APPLICATION FOR IBECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER SU ILOING `
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A:JENSEN;SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS 6T.
RECEPT. TOTAL I NO. I EACH EE
OUTL$TS FI DD 20 ."1 S.zO 6 Q OWNER
LIGHT --LY- -/-4 !/ MAIL
BwITCN.. OVER 20 / `-,0 ADDRESS
O
TOTAL rC1TY TE
LIGHTING
FIRST 20 0 .20
FIXTURES A00'L t0 ELECTRICIA
OV R 20
RANGES CLO.DRYER WTF.HTR9. 1.00 ADORES
GARB.D19P. A.COOK -
`CITY TEL. NO. (,Z
:ARB.
AUTO.-WASH. / STATE
✓ LICENSE NO. �- 3
SPACE HTRB. BTA.APR.('A H.P.MAX.) ,50 a
MOTORS: OVER - NOT OVER H.P. DISTRICT NO. GROUP ZO E CESS ED BY
o 1 1.00 p
INSPECTION
1 s Iso cR�eE�CORD
s B -2.00 1 1 nihil /hvfi r. LfZdi�
6 15 2.50 /<..�'r NI A ✓'.. ,�' O
15 50 5.00 I _ _ Q� /J U
50 100 5.00 • O= / �s�/jam /t( A =
_ Lrt,7JG ,�f,7 0
I' SIGNS: NO.TRANB� _. _ -. �l//����y/J, /� � '• LU
NO.LAMPS / - l'f( ..W
1
SERVICE O-600V-NOT OVEri'200A 1.00 III ,yj,�j / Z
SERVICE O.600V-OVER 200 A. 2.00 .T ' J`7 ° a �� ._..fit/A2
t SERVICE OVER 600V 5.00 If
' MISC.
PERMIT ISSUING FEE 2.00 /;/;2 1 df,7,A ax 11% f434
` SUPPLEMENTARY PERMIT ISSUING FEE
., TOTAL FEE
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATON 'APPROVALS DATE INSPECTOR'S BIGNATURE A�
ANO STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL 'COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANO/OR z
LICENSED A9 REQUIRED BY`LO6 ANGELES COUNTY AND STATE OF FIXTURES /
CALIFORNIA OR THAT 1 AM THE GAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL P P Y. POWER , rp /J•I / /1} ,pf � I/
OFPERMITTEEIGNATURE
O ° UTILITY CO.NOTIFIED
FINAL
VALIDATION ARTHUR'C. VEIT'
MO) CASH SUPERVISING ELECTRICAL ENGINEER'
C�.io1 5 1 21 FES 28 2 D 20.40—
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