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76A663-CE806 B-62 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT'OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE, COUNTY ENGINEER
WILLIAM A JENSEN, SUPT OF BUILDING LOCALITY
NEAREST
-FOR APPLICANT TO FILL IN CROSS sT
RECEPT TOTAL NO EACH FEE
OUTLETS FIRST 20 $.20 $ OWNER
LIGHT MAIL
SWITCH OVER 2VER2 10 ADDRESS
0 A �
LIGHTING TOTAL 11R5T20 20 CITY �p�1
FIXTURES r ADD'L 10 ELECTRICIAN
0V9R 20
RANGES CLO DRYERS WTR HTRS 1.00 ADDRESS
GARB DISP STA COOK
CITY TEL NO
DISHWASH AUTO-WASH STATE
SPACE HTRS STA APP (+/i H P MAX ) 50 LICENSE
MOTORS OVER NOT OVER H P DISTRI T N GR UP ZO
O 1 100 Ll
1 3 150 INSPECTION RECORD
3 B 200
8 15 250
15- 50 300
50 100 Soo 0
SIGNS NO TRANS
NO LAMPS t0.'
SERVICE 0.60OV-NOT OVER 200A loo (y
a
SERVICE 0.60OV-OVER 200 A 200 V)
SERVICE OVER 600V 500 ?
MISC
PERMIT ISSUING FEE 200
SUPPLEMENTARY PERMIT ISSUING FEE 100
TOTAL FEE $
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION V 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 G
ELECTRICAL WIRING WIRING _3h1A4.5
1HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELS UNTY-AND STATE OF FIXTURES
CALIFORNIA OR THAT SAM THE LEGA NE F THE ABOVE
DESCRIBED RESIDENTI P OPE POWER
SIGNATURE UTILITY CO NOTIFIED
OF PERMITTEE FINAL
VALIDATIARTHUR C. VEIT
CK MO JCAH SUPERVISING ELECTRICAL ENGINEER
LAAO 3 3 !E hltlit 2 D 3.0 0— a
TEMPLE C5Ty
76A663-CES06 B-62' APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY UILDING AND SAFETY DIVISION BFA d 4;/DRE68 / �1
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A JENSEN, SUP T OF BUILDING CALITYAREST
',,FOR APPLICANT TO FILL IN OSS ST
RECEPT TOTAL FIRST 20 IO EACH $ FEE (] OWNERI-' A.
LIGHT OUTLETS 20 MAIL � )
SWITCH ADD'L ,10 ADDRESS,/o OVER 20
LIGHTING TOTAL FIRST 20 20 (01 CIT TEL NO
FIXTURES ADD'L ELECTRICIAN
� �-V
R 20 10
RANGES CLO DRYERS WTR HTRS 100 ADDRESS
GARB DISP STA COOK _ CITY TEL NO
DISHWASH AUTO-WASH STATE _
SPACE HTRS STA APP (yy H P MAX ) 50 LICENSE NO
MOTORS OVER NOT OVER H P DIST .0 NO. GROUP ZONE PROCESSED BY
0 1' 1 bo .�, T ( L-0cV K cs
1 3 150 INSPECTION RECORD
3 a 200
8 15 250
13 50 300
IL
SO 100 Soo Q
SIGNS NO TRANS d'
NO LAMPS O
H
SERVICE 0.600V-NOT OVER 200A 100 W
a
SERVICE 0.60OV-OVER 200 A. 200 Z
SERVICE OVER 600V 500
MISC
I -
PERMIT ISSUING FEE 200 Z c
SUP.PLEMENTABY PERMIT ISSUING FEE 100
TOTAL FEE 3 2�
IHEREBY'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 J
1 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 WNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY POWER ,
i
SIGNATURE UTILITY CO NOTIFIED
OF PERMITTEE
FINAL, 3 -(o
VALIDATIO ARTHUR C. VEIT�
CK MO ASH SUPERVISING ELE ICAL ENGINEER
APR 9 2 D 3.2'0 v