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76A663-CE806 8-62 APPLICATION FOR ELECTRICAL ERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER 7NEAREST
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BUILDING AND SAFETY DIVISION 7 C fdl
JOHN A LAMBIE COUNTY ENGINEERG:
WILLIAM A JENSEN, SUP T OF BUILDING ['y
FOR APPLICANT TO FILL IN ��s NA InRECEPT (jTOTAL NO EACH FEE / //
,pt OUTLETS FIRST 20 q $ 20 $ OD MWNER G lS G A.). /C
LIGHT 11p�/ /L aC..O
SWITCH ADD'L 1O ADDRESS
OVER 2O
LIGHTING TOTAL "20 20 G CITY ��++ TEL NO
FIXTURES +o O ELECTRICIAN pJllr
RANGES CLO DRYERS WTR HTRS 100 ADDRESS ;�W v S
GARB DISP STA COOK
" CITY �L�Nr� d� TEL NO
DISHWASH AUTO WASH STATE �^
SPACE HTRS STA APP (A H P MAX ) �/ 50 d LICENSE NO
MOTORS OVER NOT;OVER H P 1 0o DIST�2OICo NO GROUP NE PAQCESSE BY
�� O 1
+ 3 15o INSPECTION RECORD
3 8 200 to — 7 6Q —
8 15 250 a -- —
o Lr
15 50 300 I
EL
50 100 500 O
U
SIGNS NO TRANS
NO LAMPS O
H
SERVICE O 600V NOT OVER 200A 100 O U W
SERVICE O 600V OVER 200 A 200 d
N
SERVICE OVER 600V 500 ?
MISC
PERMIT ISSUING FEE 200 O
SUPPLEMENTARY PERMIT ISSUING FEE 1100
TOTAL FEE a
1 HEREBY ACKNOWLEDGE THAT 1 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
ELECTRICAL WIRING WIRING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED ANO/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES _ _
CALIFORNIA OR THAT I AM THE LEGAL OW OF THE ABOVE y
DESCRIBED RESIDENTIAL PROPERT POWER
SIGNATURE UTILITY CO NOTIFIED
OF PERMITTEE -f F-
FINAL
LI ARTHUR C VETT
CK MOO CASH SUPERVISING ELECTRICAL ENGINEER
Lilo 4 4 9 61 OCT 2 2 D 24.80-
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