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76A663-CE80610-61 APPLICATION FOR ELECTRICAL PgRMIT
COUNTY OF LOS ANGELES
DEBPUILDING AND SAFETY DIVISIONNT OF COUNTY ADDRESS �� 2
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A.JENSEN, SUP'T OF BUILDING LOCALITY (E7
NEAREST
FOR APPLICANT TO FILL IN CROSS ST. 0 �S
1 T E M NO. EACH FEE
OUTLETS: (FIRST 20) $.20 $ QWNER�I�t/1/li �� /j✓if/C
LIGHTS RECEPT. SW. MAIL
OUTLETS: (ADD'L UNITS) 10 _ADDRESS
LIGHTS RECEPT. SW.
LIGHTING FIXTURES: (FIRST 20) .20 CITY TEL. NO. /
LIGHTING FIXTURES: (ADDITIONAL) .10 ELECTRICIAN O V
RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS _
GARB.DISP. STA.COOK CITIs ' i EL.NO
DISHWASH. AUTO.-WASH. STATE
/
SPACE HTRS. STA.APP.(yx H.P.MAX.) .50
LICENSE NO.
MOTORS: OVER NOT OVER H.P. DISTRjCT NO GROZ NE PR CES L� BY
O 1 1.00
3 1.50 INSPECTION RECORD a
3 s 2.00 O
u
8 15 2.50
15 50 3.00
50 100 5.00
a
SIGNS: NO.TRANS.
NO.LAMPS
SERVICE 0.60OV-Nor ovER 200A 1.00
SERVICE 0-60OV-OVER 200 A. 2.00
SERVICE OVER 600V 5.00
MISC.
PERMIT ISSUING FEE 2.00
SUPPLEMENTASY PERMIT ISSUING FEE 1.00
TOTAL FEE $
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APP (CATION 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
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 A LEG L O NER OF THE ABOVE
DESCRIBED RESIDENTIAL P OPERTY POWER
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITTEE
FINAL +!CK -
LIDATION ARTHUR C. VEIT
MO CASH
SUPERVISING ELECTRICAL ENGINEER
4 -1
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