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DBS.SA APPLICATION FOR ELECTRIC PERMIT 1
if-SS �
DIVISION OF BUMI)ING AND SAFETY
Depar ent of County Engineer BUILDING
County of Los Angeles ADDRESS �T
JOHN A.LAMBIE.COUNTY ENGINEER -)Z&
NGINEER / / e
CASSATT D.GRIFFIN, SUPT OF BUILDING LOCALITY (P [ C Y�
FOR APPLICANT TO FILL IN NEAREST
PERMIT FEES CROSS ST. e
NUMBER OWNER
LIGHT OUTLETS MAIL
RECEPTACLES ADDRESS
WALL SWITCHES FEE CITY TEL.NO.
TOTAL OUTLETS @ 5¢ $ ELECTRICIAN
ELEC. RANGES 25 ADDRESS
ELEC. HEATERS 25
CITY TEL NO
IC1M1/EA STATE
FIXTURES 5 LICENSE NO. .1
MOTORS DISTRICT NO. GROUP ZONE EADY FOR INSPECTION
NUMBER HORSEPOWER FEE ap,..2v el
NEW MVD. HP OVER INC. EACH
,h&LESS $ .25 INSPECTION RIPCORD
14 2 .50
2 5 1.00
5 15 1.50 ..'.I-
I B
-•...,.15 50 2.50 `
50 200 5.00 n� r
.09
MISC. r
h- t._=
NO.SIGNS NO.TRANS.
NO. SIGNS NO. LAMPS
FOR EACH PERMIT:
r
WIRING $1.00
FIXTURES $1.00 00,
SUPPLEMENTARY .50
APPROVALS
TOTAL FEE $ DATE INSPECTOR'S SIGNATURE
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING
ELECTRICAL WIRING.
LLCALIFORNIA
EREBY CERTIFY THAT I AM ERLY REGIST A R FIXTURES
SED AS REOUIR Y LOS COUNT N S 0
OR T AM T LEGAL OWNE O i E WER
RIBED RESID PRO TY. p
ATURE UTILITY CO.NOTIFIED ✓
PERM ITT ip a FINAL �' «*
gill
JOHN A.LAMSIE.COUNTY ENGINEER ATION ARTHUR C.VEIT.CHIEF ELECT. INSPECTOR
CT
CASH
. A ,o 5 7 8 2 MAy 7 4 .05