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76AGOB 66 Cl 1009 APPLICATION FOR ELECTR C PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEERBUILDING p�
BUILDING AND SAFETY DIVISION ADDRESS D t
JOHN A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PERMT = CROSS ST
r
1 T E M NUMBER I EACH FEE OWNER
ap
OUTLET /I�SW J $ $ MAIL
LIGHTS RECEPT 206, / 10 2.0ADDRESS
LIGHTING FIXTURES 10 A0 CITY TEL NO
ELEC RANGES CLO DRYERS ELECTRICIAN
WATER HEATERS SO ADDRESS
ELEC SPACE HTRS DISHWASHERS CITY TEL NO
GARBAGE DISPOSEi� �jo. (/ STATE 1'7898'7
WASH STA COOKING UNITS 2S s+ 0 LICENSE NO
MOTORS OVER INC
H� `JORIC�NO G.ROUPI ZONE PRO ESSED BY
O— 1/2 2S -RO:
�—1 A 9--
1/2— 2 so INSPECTION CORD
2— S too
s— is too
is— 50 250
50-200 Soo
SIGNS NO TRANS
NO LAMPS
SERVICED 600V , 100 p�
SERVICE OVER GOOV 500
MISC
WIRINGPERMIT 100 QQ
FIXTURE PERMIT too 00
SUPPLEMENTARY PERMIT SO
TOTAL FEE S 05
I HEREBY ACKNOWLEDGE THAT 1 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 A I
ELECTRICAL WIRING WIRING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR /J
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURESr�Qn ��
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIA PROPERTY POWER
SIGNATURE UTILITYCO NOTIFIED
OF PER MITTE
FINALA !
Or dDATION
ARTHUR N VETT
Mo cws� SUPERVISING ELECTRICAL ENGINEER
era
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