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PERM07 �
COUNTY OF LOS ANGELES LLJJ
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS �.�
JOHN A. LAMBIE. COUNTY ENGINEER AV
COLEMAN W. JENKINS,-SUPERINTENDENT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
a RECEPT. TOTAL NO. EACH FEE
LIGHT OUTLETS FIRST 202 $.20 $ G OWNER
MAIL
SWIT -4
CH / ADD'L -I 10 ADDRESS
--M�--� OVER 20
TOTAL FIRST 20I f .20 CITY /! TEL. NO.
LIGHTING 1 FIXTURES �•^ ,p
FIXTURES I / ADD'L 10 CONTRACTOR g'�r.
OVER 20
RANGES DRYERS WTR.HTRS. 1.00. ADDRESS / v�'v
GARB.OISP. STA.COOK
♦ ♦ CITY _ TEL. NO. _U S
DISHWASH. ! AUTO.-WASH./ /,� ��. STATE
SPACE HTRS. ` STA. APPL. / .��+ LICENSE NO. (G3 (�•%
MOTORS: OVER - NOT OVER H.P. DIS ICT FIQ., GL,LP Z P of E
0 1 1.00 R' Ce.
1 3 1.50 INSPECTION REC RD. - O
3 8 2.00 V
ce
8 15 2.50 O
F-
15 50 3.00 W
50 100 5.00 _ N
Z
` SIGNS: NO.TRANS -�
NO. LAMPS
SERVICE 0.600V-Nor OVER 200A -00 -
SERVICE 0.60OV-OVER 200 A. 2.00
SERVICE OVER 600V 5.00 -
OTHER (SEE COMPLETE FEE SCHEDULE)
a
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 APPROVALS DATE INSPECTORS SIGNATURE
TOTAL FEE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATI N UND ERS LAB WORK
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ROUGH CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING 1_
ELECTRICAL WIRING. WIRING J ,�
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO POWER
RESIDE IN,THE ABO IBED RESIDENTIAL PROPERTY.
SIGNATURE UTILITY CO.NOTIFIED
OF FERMI
- FINAL
LIDATION JOSEPH C. ROOHAN
SUPERVISING ELECTRICAL ENGINEER
CK MO CASH
. U 2 4 DLL 5 o #.7
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