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76A888 °Ee0e105' APPLICA►TIO FOR EL (CITRIC PERMIT
COUNTY OF LOS ANGELES /
DEPARTMENT OF COUNTY ENGINEER BUILDING ✓
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PERMIT MES CROSS ST
ITEM NUMBER I EACH FEE OWNER
OUTLET $ MAIL
/'� ADDRESS
LIGHTS RECEPT SW IO A
LIGHTING FIXTURES 10 e CITY TEL NO
ELEC RANGES CLO DRYERS ELECTRICIAN
WATER HEATERS SO ADDRES Q
ELEC SPACE HTRS DISHWASHERS CITY ^ T
ARBAGE DISPOS AUTO
�✓ STATE
WASHERS STA COOKING UNITS I 25 LICENSE NO
MOTORS OVER INC H P DISTRICT NO GRO P I ZONEP ESSED BY
0— 1/2 25
1/2- 2 50 INSPECTION RECORD
2— 5 100
5— 15 150
is— 50 250
50-200 Soo
SIGNS NO TRANS
NO LAMPS
SERVICE O 600V 1 00 Q�
SERVICE OVER 600V Soo
MISC
WIRING PERMIT loo Q
FIXTURE PERMIT 100
SUPPLEMENTARY PERMIT 50
TOTAL FEE S *j
IH
ACKNOWLEDGE THAT 1 HAVE READ THIS AP ICATION APPROVALS DATE INSPEC OR 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 ��
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL ROP RTY POWER
SIGNATURE UTI LITYCO NOTIFIED
OF PERMITTE
FINAL
OF /Vi .I ON ARTHUR C VETT
CK MoO CASH SUPERVISING ELECTRICAL ENGINEER
L o9 C 5 ` NOV 23 2 D 7 35 r