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76A663-CE806 8-62 APPLICATION F R ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER fo77
BUILDING AND SAFETY DIVISION JOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A JENSEN, SUPT OF BUILDING EAREST /
FOR APPLICANT TO FILL IN CROSS ST
RECEPT TOTAL NO I EACH FEE
OUT TS FIRST 20 p $20 $ OD OWNER
LIGHT Fj MAIL 1} �
ADD'L /� ADDRESS J0,S! w v
SWITCH OVER 2O 10 ,) '0
LIGHTING TOTAL F T 20 t 20 �0 CITY TEL NO
FIXTURES } �1 OVER
2 10 ELECTRICIAN
OV R RS /
RANGES CLO DRYERS WTR HTR9 100 ADDRESS
�GARB DISP I STA COOK
CITY TEL NO
DISHWASH AUTO-WASH 1 STATE '
S ACE HTRB 50
J!J U O LICENSE NO
MOTORS OVER NOT OVER HP DISTRICT N GROUP ME PR CESSED BY
O 1 100
1 3 1 so INSPECTION RECORD O o
3 8 200
8 Is 250 " +�
15 50 300 Y.
50 100 500 0
SIGNS NO TRANS w
NO LAMPS O
H
SERVICE 0.600V-NOT OVER 200A too 00 U
W
a
SERVICE 0-600V-Oven 200 A 200 c7
SERVICE OVER 600V Soo ?
MISC
PERMIT ISSUING FEE 2 00 0
SUPPLEMENTARY PERMIT ISSUING FEE 100
TOTAL FEE
I
HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI ATION 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
A
I HEREBY CERTIFY THAT 1 S PROPERLY REGISTERED AND/OR
LICENSED A9 REQUIRED BY L09 A LES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM THE GAL OWN R OF THE ABOVE
DESCRIBED RESIDENTIAL PROPE POWER 1 / •/� Q
SIGNATURE UTILITY CO NOTIFIED /
OF PERMITTEE FINAL4—
VALIDATION ARTHUR C. VEIT
CK MO 2A 1{ SUPERVISING ELECTRICAL ENGINEER
4 8.6 6;3- Am 8 2 D 17.10-
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