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76"66` CE#806 5.61 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS /ANGELES
DEPARMENT 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.
PERMIT FEES OWNER
I T E M NU...R1 EACH FEE MAIL f
OUTLET 2 $ $ ADDRESS
LIGHTS RECEPT. SW. 3 .10 n CITY TEL. NO.
LIGHTING FIXTURES 10
ELEC. RANGES CLO. DRYERS ELECTR CIAN
WATER HEATERS .50 ADDRESS
ELEC.SPACE HTRS. DISHWASHERS
CITY TEL NO. o
GARBAGE DISPOSERS AUTO.- STATE
WASHERS STA.COOKING UNITS ,25 LICENSE NO.
MOTORS: OVER INC. H.P. DISTRICT O. GR P Z NE P5PIPESSED BY
0— 1/2 .2 5 7
lie— 2 .50 INSPECTION RECORD
2— 5 1.00 d
5— 15 1.50 V
15— 50 2.50 Im
50— 200 5.00 O
U
SIGNS: NO TRANS. a
NO.LAMPS Vf
_ Z
SERVICE 0-600V 1.00
SERVICE OVER 600V 5.00
M ISC. _
WIRING PERMIT
1.00
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT :50
TOTAL FEE g
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
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT
ELECTRICAL WIRING.
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR WIRING
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM THE LEGAL OWN OF THE ABOVE
DESCRIBED RE DE AL PROPERTY. t POWER
SIGNATURE UTILITY CO.NOTIFIED
OF PERM ITT E
FINAL
VALI ARTHUR C. VEIT
cn MO
CASH SUPERVISING ELECTRICAL ENGINEER
r
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