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APPLICATION FOR ELECTRIC PERMIT 1
COUNTY OF LOS ANGELES BUILDING �- r
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION
JOHN A. LAM M, County Engineer
CASSATT D. GRIFFIN, Supt of Building LOCALITY !.
NEAREST
FOR APPLICANT TO FILL IN CROSS ST. f
PERMIT FEES
ITEM NUMBER EACH FEE OWNER (-
OUTLETS: - - $ $ MAIL
LIGHTS I RECEPT. t_ SW.; .10 - i ADDRESS
LIGHTING FIXTURES .10 , CITY TEL.NO.
ELEC.RANGES CLO.DRYERS ELECTRICIAN - - -
WATER HEATERS .50 ADDRESS '- -
ELEC.SPACE HTRS. DISHWASHERS
GARBAGE DISPOSERS AUTO.- CITY TEL.NO.
WASHERS STA.COOKING UNITS ,25 STATE
LICENSE NO.
MOTORS: OVER INC. H.P.
DISTRICT NO. GITLIP Z E READY FOR INSPECTION
O — 1/2 .25
I/2 — 2 .50 A
INSPECTION RECORD
2 — 5 1.00
5 — 15 1.50 1'
15 — 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 1.00
SUPPLEMENTARY PERMIT .50
TOTAL FEE $ APPROVALS
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM,THE LEGAL OWNER OF THE ABOVE POWER
DESCRIBED RESIDENTIALPROPBRTY. -
SIGNATURE - � UTILITY CO.NOTIFIED
OF PERMITTEE
/
FINAL
-7
LIDATIO H
ARTHUR C.VETT.
MO CASH SUPERVISING ELECTRICAL]ENGINEER
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