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78A9B9-CESOS-6-57 APPLICATION F'O ELECTRIC PERMITi
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING 1'►
BUILDING AND SAFETY DMSION ADDRESS
JOHN A.LAMBIE,COUNTY ENGINEER
CASSATT D GRIFFIN,SUPT OF BUILDING LOCALITY /
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
PERMIT FEES
�� qq OWNER
LIGHTS RECEPTACLES PA.! ' SWITCHES
NUM E ITEM EACH EE MAIL
TOTAL OUTLETS � 10 $ ADDRESS
ELEC RANGES, WATER HEATERS, CITY TEL NO
CLOTHES DRYERS so ELECTRICIANC G
d ELEC SPACE HEATERS, STAT Y COOK- .
/s ING UNITS, G.¢,Q.BJ6G,E„D,I�
AUTO WASHERS, DISHWASHER 25 ADDRESS
({ I LIGHTING FIXTURES 10 CITY �I TEL 1,1 OI
MOTORS STATE
LICENSE NO
HORSEPOWER DISTRICT G UP ON READY FOR INSPECTION
H P OVER INC r/
1/z&LE59 25
+�2 — 2 so 'INSPECTION RECORFSl� �
5 — s 1sa G7/ ��;
p
18 — so 250
,�/ OL�a,.✓1� �%1d�j�✓,-
50 — 200 5 00 -
MISC.
SIGNSI NO THAN
NO LAMPS JJ �
SERVICE O-600V 1 00 !�
SERVICE OVER 600V s 00
WIRING PERMIT -
FIXTURE PERMIT 100
SUPPLEMENTARY PERMIT 50 APPROVALS
TOTAL FEE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS A PLI ATION DATE INSPECTORS SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING O S 6
ELECTRICAL WIRING WIRING jJ
I HEREBY CERTIFY TH T l AM PROPERLY REGISTERED AT
FIXTURES
LICENSED AS REQUIRED LOS-ANGELE C TY AND ATE OF _
CALIFORNIA OR THAT THE LE N I ABOVE POWER
DESCRIBED RE NTI OPERTY. 4 l
SIGNATURE UTILITYCO NOTIFIED p'
OF PERMITTE FINAL 1--/�- / irnAi7�ni.!
JOHN A LANAIA.LANAILI ARTHUR C.VEI E
COUNTY EN R CK MOO CASH CASH SUPERVISING ELECTRICAL ENGINEER
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