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....... 7-58 APPLICATION FOR ELECTRIC PERMIT
BUILDING AND SAFETY DIVISION i 71
Department of County Engineer BUILDING
County,of Los Angeles ADDRESS
JOHN A. LAMBIE COUNTY ENGINEER
P
CASSATT D. GRIFFIN, SUPT OF BUILDING LOCALITY
NEARESTy-
FOR APPLICANT TO FILL IN CROSS ST,
PERMIT:FEES NUMBER OWNER '
LIGHT OUTLETS MAIL
ADDRESS
A RECEPTACLES
fir► WALL SWITCHES FEE CITY TEL NO.
TOTAL OUTLETS @ 5Q ELECTRICIAN ���niq ,�_d�,Rdl�/L
ELEC'RANGES 25 ADDRESS
ELEC HEATERS 25 CITY TEL. NO.
KW EA STATE -
FIXTURES 5 LICENSE NO.
MOTORS _ DISTRICT NO. JGROUPJ,�?NE
READY FOR INSPECTION
NUMBER HORSEPOWER FEE
NEW MVD HP OVER INC EACH
2 t/ I�@ LESS $ .25 INSPECTION RECORD
1f1 2 50
2 5 1 00
5 15 1.50
15 50 250
50 200 500
MISC.
NO SIGNS, NO TRANS.' -
NO SIGNS NO LAMPS
FOR EACH PERMIT
WIRING PERMIT $100 Q
FIXTURE PERMIT $1.00 -
SUPPLEMENTARY .50 APPROVALS
TOTAL FEE g Q DATE INSPECTOR'S SIGNATURE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI ATION CONDUIT - S' `C'7
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND•STATE LAWS REGULATING WIRINGJ�
ELECTRICAL WIRING FIXTURES
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
POWER
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL �,Y � UTILITY CO.NOTIFIED
SIGNATURE
OF PERMITTEE a" FINAL 7-7kS�'? f"
JOHN A. LAMBIE. VALIDATION ARTHUR C. VEIT.
COUNTY ENGINEERCK Mo CASH - SUPERVISING ELECTRICAL ENGINEER
LACo 8 5 2 MAY 24 2 4.8 0 ,n