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76A663-[E806 9-64 APPLICATION FOR ELIEjRICAL
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER rAD
DING —
BUILDING AND SAFETY DIVISION JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W JENKINS, SUPT. OF BUILDING LITY
EST
FOR APPLICANT TO FILL IN S ST.
RECEPT, TOTALNO, I EACH FEE
OUTLETS FIRST 20 $ 20 $ OWNER
LIGHT MAIL
ADD'L 10 ADDRESS
SWITCH. OVER 20
TOTAL CITY . NO.
LIGHTING FIRST 20 .20
FIXTURES }�, — I ov DRD'L 10 ELECTRICIAN
RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS O�/
GARB.DISP. STA.COOK
CITY TEL.
DISHWASH. AUTO.-WASH. STATE
SPACE HTRS. STA.APP.('/.H.P.MAX.) •50 LICENSE NO.
MOTORS: OVER NOT OVER H.P. DIST,{ICT N GR UP Z P OCE D Y
O 1 1.00
1 3 1.50 INSPECTION RECORD
a
s S 2.00 0
U
B 15 2.50
15 50 3.00 O
_ H
s0 100 5.00 V
W
a
SIGNS: NO.TRANS
NO.LAMPS N
Z
SERVICE 0.600V-Nor OVER 200A 1.00 Q�
SERVICE 0.60OV-OVER 200 A. 2.00
SERVICE OVER 600V 5.00
MISC.
PERMIT ISSUING FEE 2.00
SUPPLEMENTAgY PERMIT ISSUING FEE 1.00
TOTAL FEE $ 3
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION 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
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 LEGA OWNER OF, AND INTEND TO
RESIDE IN, THE ABOVE DESCRIBED R D NTIAL P O�ERT Y. POWER
SIGNATURE - UTILITY CO.NOTIFIED
OF PERMITTEE FINAL �V V Vo✓�
-
VALIDATION JOSEPH C. ROOHAN
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
Ao 0 3 .1 5 b MAR 9 2 D 3•,0 0
1