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�eAeea.ceaogY.ec APPLICATION FOR ELECTRICAL PERMIT 'Q
COUNTY OF LOS ANGELES -
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS +
JOHN A.LAMBIE, COUNTY ENGINEER
WILLIAM A. JENSEN, SUP'TOP BUILDING LOCALITY
N, i•FOR APPLI CANT TO FI LL I N cRoss sT Q' • .
PERMIT FEES
OWNER
Qr
NUMBER EACH FEE MAIL
OUTLET S S ADDRESS
r LIGHT9 ECEPT. SW. .10
LIGHTING FI=URE3 10 1�D CITY TEL NO.
ELEC. RANGES CLO. DRYERS ELECTRICIAN
W A E H E A T E RE .SO ADORES
SCFE.SPACE HTR DISHWASHERS CITY TEL.NO.
�CaARBADE DISPOSER AUTO.. STATE
WASHERS STA. COOKING UNITS ✓ ,2g �� LICENSE NO.
MOT R$: OVER INC. H.P. DISMICTr. G ZON
V.
Va — 2 50 INSPECTION RECORD
2 — 5 1.00 (�� y
5 — is LSO O
U
Is — So 2.90
O
SO — 200 5.00 H
U
w
SIGNS: NO TRANS. 6
NO. LAMPS N
7..
SERVICE 0.600V 1.00
SERVICE OVER 600V 5.00
MISC.
WIRING PERMIT 1.00
FIXTURE PERMIT 1,pp
SUPPLEMENTARY PERMIT ,so
TOTAL FEE $
1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTO -S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT
ELECTRICAL WIRING. WIRING G'
1 HEREBY CERTIFY. THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I Am
DESCRIBED RES'DENTI PRO TY.
TF THE ABOVE
YLEGAL NSR OPOWER
SIGNATURE4 UTILITY CO. NOTIFI D 7 �n� �Vi �illl �I AA
OF PERMITTE
FINAL
�LI ARTHUR C.VETT,
K MOo CASH
SM SUPERVISING ELECTRICAL ENGINEER
lfy q8 4 7 5 ' .rlrN 13 D 9.8 5
� L ` / I
TSA 663-CE 606 &62 APPLICATION FOR ELECTRICAL PRMIp
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDINGa / )G +
BUILDING AND SAFETY DIVISION ADDRESS O�`OO
JOHN A. LAMBIE, COUNTY ENGINEER •
WILLIAM A.JENSEN, SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST. . vF
RECEPT. TOTAL NO. EACH FEE
OWNOUTLETS LFIR
201 $ 20 $ MAIL �/I[' S.
LIGHT MAIL
swliCH. - OVERADD-L .10 ADDRESS �
TOTAL CITY TEL. NO. _?277-,?
LIGHTING 1 201 .20FIXTURES If 'L 1OELECTRICIAN 2 0 Z'
GARB.RANGES cL Fw3 WTR.HTRS. I 1.00 ADDRESS (J I / Pr Z'/ +
GARB.DISP. BTA.COOK
CITY TEL. NO. f l IY
DISHWABH. AUTO.-WASH. STATE r
SPACE HTRS, BTA.APP.(1/.H.P.MAX.) .50 LICENSE NO.
Morons: OVER NOT OVER H.P. DISTIj�ICT GRQUP ZONE P CESSED BY
o f / Lv
1 3 I.So INSPECTION RECORD
3 — B 2.00
B 15 2.50
IS 50 3.00 - }
D.
50 100 5.00 O
SIGNS: NO.TRANB- K
NO.LAMPS O
SERVICE 0-600V.NoT OVER 200A 1.001 1
SERVICE 0-600V-OVER 200 A. 2.00 1
V7
SERVICE OVER 600V 5.00 z
MISC.
PERMIT ISSUING FEE 2.00 U
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING I� gg
ELECTRICAL WIRING. - WIRING G/IG.J
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR /
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE70F FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIIAAL"PPRROPERTY. POWER
81GNATURE �/'.l ,1AC A"!1 UTILITY CO.NOTIFIED //�/^ s
OF PERMITTEES lV ��'666 L! P 9
FINAL
VALIDATION ARTHUR C. VEIT
C MO CASH SUPERVISING ELECTRICAL ENGINEER
U11CO 3 4 1�55 APR 1:6 2.; D 3..(')0- v