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76A663-CE806 5.62 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING n '
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A.JENSEN, SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN
REC EP T. TOTAL NO. I EACH FEE
LIGHT OUTLETS FIRST 20 D$20 $ O _OWNER
ADD'L10 ADDRESS
SWITCH. / OVER 20 T/
LIGHTING TOTAL FIRST 20 .20 CITY TEL. NO.
FIXTURES ADD'L 10 ELECTR CIA
OVER 20
RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRES -
GARB.DISP. STA.COOK
CITY TEL. NO. C^
DISHWASH. AUTO.-WASH. STA E 7
{� �-
SPACE HTRS. STA.APP.(1/z H.P.MAX.) ,50 (f LICENSE NO.
MOTORS: OVER NOT OVER H.P. DISTRICT NO. GROUP I ZONE PROCESSED BY
O 1 1.00 , U !� 1 A-- Goma, r
1 3 1.50 INSPECTION RECORD
3 8 2.00
8 15 2.50
O
15 50 3.00 V
K
50 100 5.00 - O
H
SIGNS: NO.TRANS W
NO.LAMPS
CIL
N
SERVICE 0.600V-NOT OVER 200A 1.00 g9 c Z
SERVICE 0-600V-OVER 200 A. 2.00
SERVICE OVER 600V 5.00
MISC.
PERMIT ISSUING FEE 2.00
SUPPLEMENTAFY PERMIT ISSUING FEE 1.00
TOTAL FEE $ ,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLIC TION 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
I ELECTRICAL WIRING. f
I WIRING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIREDBY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PRO ERT POWER
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITTEE
FINAL
YALIDATION ARTHUR C. VEIT
l/C�/K/") MO CASH SUPERVISING ELECTRICAL ENGINEER
25o2 HAR26 0 1 4.10N