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7GA663-CESO6 10-59
APPLICATIOeELECTRIC PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEERTUILDING //�� / C/ 2
BUILDING AND SAFETY DIVISION /A'/ �(0JOHNA. LAMBIE, CgUNTY ENGINEER
WILLIAM A.JENSEN.SUPT OF BUILDING FOR APPLICANT TO FILL IN PERMT FEES CROSSST.
1 T E M NUMBERI EACH FEE OWNER
OUTLETS: / $ $ MAIL °
LIGHTS I/ RECEPT./ SW. 10 ADDRESS
LIGHTING FIXTURES // ` ' 10 CITY TEL NO.
ELEC.RANGES CLO.DRYERS ELECTRICIAN
WATER HEATERS .50 - ADDRESS
ELEC.SPACE HTRS. DISHWASHERS � �
CITY �T"Q{�Cs'1'�C�( TEL. NO. 6 .2 7 P VP
GARBAGE DISPOSERS AUTO.- STATE O G�
WASHERS STA.COOKING UNITS .25 LICENSE NO. / 6
MOTORS: OVER INC. H.P. DIST��CT NO. I GR ZONE P ESSED BY
0- 1/2 .25
1/2— 2 .50 INSPECTION RECORD
2— 5 1.00
5— 15 1.50
is— 50 2.50
50-200 5.00
SIGNS: NO.TRANS.
NO.LAMPS
SERVICE'0-600V 1.00
SERVICE OVER 600V 5.00
MISC.
WIRING PERMIT 1.00
FIXTURE PERMIT 100
SUPPLEMENTARY PERMIT .50
TOTAL FEE $
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP LIGATION 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.
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR WIRING
LICENSEAS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORND IA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE _
DESCRIBED RESIDENTIAL PROPERTY. POWER
SIGNATURE o✓ �,"1//2 UTILITY CO.NOTIFIED / Q j
OF PERMITTEE / V
- SS --ii FINAL
®r I O CON SUPERVISING
R C.VEIT,
L/./c�K Mo CASH SUPERVISING ELECTRICAL ENGINEER
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