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76A66C-CE#806 5-61
APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARMENT OF COUNTY ENGINEERt% BUILDING
BUILDING AND SAFETY DIVISION �� ADDRESS �✓V !�
JOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY �v
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
PERMIT FEES OWNER
1 T E M. NUMBERI EACH FEE MAIL
OUTLE S S ADDRE
LIGHTS RECEPT W. •tp CITY TEL.
LIGHTING FIXTURES •10
ELEC. RANGES CLO. DRYERS FLF=RIZAN
WATER HEATERS .50 tADDS
ELEC.SP E HTRS. DISHWASHERS
XE L NO.
GARBAG DISPOSERS f AUTO.- 2
WASHERS STA.COOKING UNITS 1J •25 E NO.
MOTORS: OVER INC. H.P. ICT O. OUP Z E P SSED B
0— 1/2 .25
1/2— 2 .50 INSPECTION RECORD
2— 5 1.00 O
5— 15 1.50 •- �
15— SO 2.50 BC
0
50— 200
5.00 U
W
SIGNS: NO TRANS.
NO.LAMPS N
SERVICE 0-600V 1.00
SERVICE OVER 600V 5.00
misc.
WIRING PERMIT 1.00
FIXTURE PERMIT f.00
SUPPLEMENTARY PERMIT 50
TOTAL FEE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPL
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATINGY CONDUIT nn // �'•�'//�J�
ELECTRICAL WIPING. WIRING
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR �7
LICENSED AS RE"R BY LOS AN ELES OU Y NO STATE OF FIXTURES R• ',(/
CALIFORNIA OR THAT A THE GAL W THE ABOVE f ,
DESCRIBED RESIDENTI P ERTY. POWER
SIGNATURE UTILITY CO NOTIFIED
OF PERMITTEE FINAL p/L. �►d "'"�
I DATION ARTHUR C. VEIT
01111 MO CASH SUPERVISING ELECTRICAL ENGINEER
( ,5 4 1 7-104 • N 24 2 D 1. 1 .00 �