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7eAa"-CEEoe,o-a, APPLICATION FOR ELIECTRICAL PERMIT
COUNTY OF LOS ANGELE
DHPARTMENT OF CO-LINTY ENGINEER ]BUILDING / C
BUILDIN¢ '(4ND S FETY DIVISION ADDRX" O
JOHN A. LAMBIE,OUNTY ENGINEER
WILLAYLJJAY A..fENSEN,SUWT OF]BUILDING LOCALITY
NF1.REfT
CROSS ST.
I r E NO /
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LIGHTING FIXTURES, (ADDrTio L) .1 ELECTRICIAN /G
If
RAmms CL,O,DRYw Vrm HTW. 1.00 ADDRSSS
GAIW.DIEL. ETA.COOK aTQC N
DISHWASH. AUTp.•WAEH. STA,3t / C� O
STAG IT l
H77W - ETA.AIT.(Y.H .MAX.) ,50 LI C[NO[ Na
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1 3 1,50 • INSPECTS N R5CORD
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80 100 E.00
SIGHS, No.TRANS.
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omrvIC[o•6QOV-ovu 4,00 A. 2.00
SERVICE OVER EOoV ]B.OQ
MIQC
P[RHIT ISSUING FEI l..00
SUPPL UMENTARY PIMMIT IMUING F1Q 1.00
TOTAL FEE #
I HIRE=Y AC"OWLmOZ THAT 1 +SAVE READ THIS AFFUCATION DATE
AND STAT[ THAT THE ABOVE IS COIERCT AND AGS TO COW-LY CONDUIT
WITH ALJ. COUNTY ORDINANCES AND &TATE LAME AEGULATING
KLKCrPooAL VFU"G• WIRING f
1 MIMI Y CERTIFY THAT 1 AY FROPOILY R=Glwrz m AND/Ok
I..ICEN&ED AS Rlqu D•m EY Lbi ANGiLks COUNTY A)(D &TAT& OF FOCTURiO
CkUFORNIA OR THAT I AY THE LEGAL OWNER Of THE ANOV[
DESCIff"M wmo+TlwLPtrlr. ! 0oWlat
SIGNATURE UTILYIY CO.NOTIFl
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OF PER
FINAL
VALI/ A [3R C VEST
cx SLIP[RV181NG El[CTRICAL EiiGIN[!6#
2 1 0 7Qf JkL 2 5 2 B 860-
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