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76A66S-CES0610-60 APPLICATION FOR ELECTRICAL PERMIT 1
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 i
hl NEAREST •' r'y ,
FOR APPLICANT TO FILL IN CRosS sT.
PERMIT FEES OWNER
I T E M NUMBERI EACH FEE MAIL L
OUTLET : gIp 4 ADDRESS
LIGHTS RECEPT. SW. Y CITY TEL NO.
LIGHTING FIXTURES t Ip r ,• �j
ELEC. RANGES CLO. DRYERS ELECTRICIAN
WATER HEATERS .50 ADDRES
ELEC.SPACE HTRS✓DISHWASHERS /
CITY Qev-<.• .{ _��(- TEL NO.A' `✓
GARBAGE DISPOSERS AUTO.- _ STATE /
WASHERS STA.COOKING UNITS ,25 �- LICENSE NO. (�—
MOTORS: OVER INC. H.P. DISTRICT IVO. G ZONE
� I P ESSED BY
0— 1/2 .25 LS
i
1/2— 2 .50 INSPECTION RECORD
2— 5 1.00 aO
5— 15 1.50 U
15— 50 2.50 0
O
50— 2005.00 IV
SIGNS: NO TRANS. D"'
NO.LAMPS h
Z
SERVICE 0-600V 1.00
SERVICE OVER 600V 5.00
MISC.
WIRING PERMIT 1.00 .r
FIXTURE PERMIT 1.00 GI
SUPPLEMENTARY PERMIT 50
TOTAL FEE g
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE 15 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 OF THE ABOVE
DESCRIBED RESIDENT IA P OPER POWER
SIGNATUREr�'{* - j E9 - UTILITY CO.NOTIFIED -
OF PERMITTEE
4.4 FINAL
.DATION ARTHUR C. VEIT
cK Mo cases SUPERVISING ELECTRICAL ENGINEER