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78A66 DBB.SA 11.88 APPLICATION FOR ELECTRIC PERMIT 1
DIVISION OF BUILDING AND SAFETY
DepOxtment of County Engineer MF
UILDING U
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County of LOB Angele8 ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PERMIT FEES CIROSS ST.
NUMBER
OWNER
LIGHT OUTLETS :1
MAIL
RECEPTACLES ADDRESS
WALL SWITCHES FEE CITY TEL. NQ.
TOTAL OUTLETS 0 S¢ $ D
ELECTRICIAN
'y—
ELEC. RANGES 25 ADDRESS V
ELEC. HEATERS 25
CITY TEL.N
KW EA STATE
FIXTURES S LICENSE NO. `4
MOTORS DISTRICT NO. I GROUP I ZONE I READY FOR INSPECTION
NUMBER HORSEPOWER FEE
NEW MVD HP OVER INC. EACH
g LESS $ 25 INSPECTION RECORD
Yz 2 .50
2 8 1.00 � r
S 18 1.80
1s 50 2.50
50 20o A0 +" V r"4t
M ISC.
NO.SIGNS NO.TRANS.
NO. SIGNS NO. LAMPS
FOR EACH PERMIT:
WIRING $1.00
FIXTURES $1.00
SUPPLEMENTARY .50 APPROVALS
TOTAL FEE S G DATE INSPECTORS SIGNATURE
IHEREBY ACKNOWLEDGE THAT 1 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
ELECTRICAL WIRING.
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM HE LEGAL OWNER OF THE ABOVE POWER
DESCRIBED RESIDENTIA O RTY.
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITTEE FINAL
JOHN A.LAMBIE.COUNTY ENGINEER VALIDATyA ARTHUR C.VETT.CHIEF ELECT. INSPECTOR
CK MO .1CA�B
LATO 2 6 4 U DEC 11 2 1 .1 0