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APPLIC�+TIORI '- �t ELECT IC PERMIT
COUNTY OF LOS ANGELES - -- _ - •—
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS �� �•'+•1+ '
JOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A.JENSEN.SUPT OF BUILDING } LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PERMIT FEES CROSS ST.
ITEM NUMBER OWNER EACH FEE MAIL L
OUTLET" 6 $ ADDRESS
LIGHTS REOEPT2SW. .10 C
LIGHTING FIXTURES 13 .f0 CITY TEL.NO.
ELEC.RANGES CLO.DRYERS ELECTRICIAN
WATER HEATERS .50 ADDRESS 9923 F- RROAT)WAY
ELEC.SPACE HTRS. DISHWASHERS
CITY SAN GARRIET, TEL. NO.
�nwwnnF STATE p p
WA STA.COOKING UNITS .25 �` LICENSE NO. V V f
MOTORS: OVER INC. H.P. e9DISTRICT-NPR CE55ED BY
O— .25 GOI �FI
'A- 2 .50 INSPECTION RECORD
2— 5 1.00
5- 15 50
15— 50 2.50 / •-
50-200 5.00
SIGNS: NO.TRANS.
NO.TAMPS
SERVICE 0-600V 1.00 f 00
SERVICE OVER 600V 5.00
MISC.
WIRINGPERMIT 1.00 00
FIXTURE PERMIT 1.00 QB
SUPPLEMENTARY PERMIT .50
TOTAL FEE S e 47'
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'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 U
1 HEREBY CERTIFY THAT I S PROPERLY REGI5AND ATC OF J /
LICENSED AS REQUIRED A LOB ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 R THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDE L PROPERTY. � POWER f
SIGNATURE /- UTILITY CO.NOTIFIED 411t,111.1 Or
OF PERM ITTE is c
FINAL /I ✓
®P DATION ARTHURVETT,
SUPERVISING ELECTRICAL ENGINEER
CK MO CASH
n5 �c3715 2D 9.55 "