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V-fie APPLICATION FOR ELECTRIC PERMIT `
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING � 7 u '
BUILDING AND SAFETY DIVISION AODRES$ / 1
JOHN A. LAMBIE, COUNTY ENGINEER
CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PERMTf FM CROSS ST
I T E M UMBERI EACH I FEE OWNER
OUTLETS: /. MAIL
LIGHTS /'RECEPT. 2--SW. ' $.10 S / 1i ADDRESS
LIGHTING FIXTURES .10 CITY
ELEC. RANGES CLO. DRYERS ELECTRICIAN
WATER HEATERS .50 ADDRESS
ELEC.SPACE HTRS. DISHWASHERS
CITY TEL. NO.
GARBAGE DISPOSERS AUTO.-
STATE
LICENSE
WASHERS STA. COOKING UNITS .25 LICENSE NO.
MOTORS: OVER INC. H:P. -
DISTRICT NO. I GROUP ZONE I PR CESSED BY
0— V, .25 s
.50
INSPECTION RECORD
2— 5 1.00
5— 15 1.50
15— SO 2.50
50-200 5.00 J />, AS 7 rc <o+/r rrPs'A /E-z -
SIGNS: NO. TRANS. ^/b
NO. LAMPS
/K67H I-t r971U�!
SERVICE 0-600V 1.00 /
SERVICE OVER 600V 6.00 �-
MISC.
7 CJ7rT Q/�c r' ul/Q�
Mu 7U 4—
WIRING
WIRING PERMIT 1.00
FIXTURE PERMIT - 1.00ria�et�i•
SUPPLEMENTARY PERMIT .50 u �"'I�^"r_S _. S
TOTAL FEE sJVI APPROVALS -r `•
1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION DATE INSPECTOR'S SIGNATURE
ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING /'� 1 O t ]�•V'��/
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM E LEG OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL P P POWER
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITTEE
_ FINAL � G• Lo �� �^f
Vj;j,[])}[� ARTHUR C. VETT,
V D CASH SUPERVISING ELECTRICAL ENGINEER
a 1 0 1 n "NOV 2 5 2 A 4.1 0
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