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`I1'EMPLE COPTY
APPLICATION FOR ELECTRICAL PERMIT Q
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER rA'CDRESS
ILDING
BUILDING AND SAFETY DIVISION e,JOHN A.LAMBIE, COUNTY ENGINEER
WILLIAM A. JENSEN. SUPT OF BUILDING CALITY P>>
FOR APPLICANT TO FILL IN NEAREST �� '
CROSS ST.
PERMIT FEES OWNER N, R A G, C- %1_
ITEM NUMBER EACH FEE MAIL Op
'OUTLETS. S S ADDRESS
LIGHTS RECEPT. SW. .10
LIGHTING FIXTURES 10 CITY TEL NO Ji
ELEC. RANGES CLO. DRYERS ELECTRICIAN
`� .
WATER HEATERS .30 ADDRESS
ELEC.SPACE HTRS. DISHWASHERS CITY T O.
GARBAGE DISPOSERS AUTO.. STATE
WASHERS STA.COOKING UNITS .23 LICENSE NO.
MOTORS: OVER INC. H.P. DIST ICT NO. GROUP ZONE PR ESSED BY '
0 — V. .25
V - 2 50 INSPECTION RECORD
2 5 1.00
3 13 �!
7. OU
30
30
15 50 2. V
O
30 200 9.00 ~
V
W
SIGNS: NO TRANS. N
NO, LAMPS
7.
SERVICE O-SOOV 1.00
SERVICE OVER SOOV 5.00 '
M15C.
WIRING PERMIT
1.00
FIXTURE PERMIT I.
SUPPLEMENTARY PERMIT ,gp
TOTAL FEE IS
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS' tDATEINSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE 15 CORRECT ANO AGREE TO COMPLYCONDUITWITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING. WIRING 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 THE LEGAL OWNEDESCRIBED RESIDENTI 0 ERTY. POWERSIGNATURE UTILITY CO. NOTIFIEOF PERMITTE FINA
(DATION ARTHURC.VEIT.
SUPERVISING ELECTRICAL ENGINEER
C MO CASH
4 6 4 4 MAR 3 0 2 D 2 .50 kD