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76A 663.,CE 806 B-62 APPLICATION FOR ELECTRICAL PERMIT
r COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A JENSEN, SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.TNP4
o D
RECEPT. TOTAL NO EACH FEE
OUTLETS FIRST 20 $20 $ /- OWNER U '
LIGHT MAIL �.
ADD'L 10 ADDRESS
SWITCH � OVER 20
LIGHTING 1 TOTAL F)RST 20 .20 CITY TEL. NO.
FIXTURES Jr ADD'L 1O ELECTRIZ
OVER'
V R 20
RANGES CLO DRYERS WTR.HTRS 1.00 ADDRESSGARB.DISP. STA COOKCITY TEL NO.
DISHWASH. AUTO.-WASH. STATE /�
SPACE HTRS STA.APP.(y:H.P.MAX.) ,50 LICENSE NO. G
t
MOTORS. OVER NOT OVER H.P. DISTRICT
�J7V0 G O Z E P D
0 1 1.00 i ✓ r
1 3 1,50 INSPECTION RECORD
3 S 2.00
s 15 250
15 50 3.00
Q_
50 100 500 O
SIGNS NO.TRANS lwO
NO LAMPS
H
SERVICE 0-60OV-NOT OVER 200A 1.00 W
CL
SERVICE 0-60OV-OVER 200 A. 2.00 Z
SERVICE OVER 600V 5.00
MISC.
PERMIT ISSUING FEE 2001
SUPPLEMENTARY PERMIT ISSUING FEE 100
TOTAL FEE i
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE / INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT / I /. //SI
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING WIRING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED ANO/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES (/
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER F THE ABOVE
DESCRIBED RESIDE A PROPS Y POWER
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITT FINAL
VALIDATION `ARTHUR C. VEIT� f '
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
rQ
Lr l,o 7 0 5 81 [•',R 2 7 2 D .6 0...
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TEMPLE CUTS'
76A663-CE806 X82 ' APPLICATION FOR ELECTRICAL PERMIT
COUNTY,OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING �� L� �, q
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A JENSEN, SUPT OF BUILDING LOCAizz
LITY .� i
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
RECEPT33 TOTAL NO, EACH FEE
OUTLETS FIRST 20 ffi 20 6� OWNER
LIGHT41f 9 MAIL
SWITCH ADD'L 10 ADDRESS �, M
_ OVER 20
TOTAL CITY TEL NO.
LIGHTING FIRsr 20 20
FIXTURES } V D0 10 ELECTRICIAN — "I
OV R 20 ``
RANGES CLO DRYERS WTR HTRS. 1.00 ADDRESS 'V O I S
GARB DISP.,�- STA.COOK Q
CITY" TEL.NO. E k-S( ,1
DISH WASH AUTO.-WASH. STATE ` ^
SPACE HTRS STA.APP (/a H P.MAX.) .50 D LICENSE NO. b
MT S, v NOT OVER ' H P. DISTRICT NO. GROUP ONE PROESSED Blj
O 1 11 ! 1.00
1 3 1.50 INSPECTION RECORD
3 8 2.00
8 15 t 2.50
15 50 300 y�✓�/a fa �n 1,. ' �� IL
50 100 500 G 4 Q/ O
SIGNS NO.TRANS �'(f' 0
N0_1O.LAMPS
I.—
SERVICE 0-600V•NoT OVER 200A 1.00
SERVICE 0-60OV-OVER 200 A. 2.00 H
SERVICE OVER 600V 5.00 ?
MISC
PERMIT ISSUING FEE 200 O
SUPPLEMENTARY PERMIT ISSUING FEE. 1.00
TOTAL FEE 7`b -$449,
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION 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
ELECTRICAL WIRING. WIRING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM THE LEGAL OWNER F THE ABOVE
DESCRIBED RESIDEN PROPERTY. POWER
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITTE
LIDATION ARTHUR C. VEIT '
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
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