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ieAceyceeos s.aa APPLICATION F®R ELECTRIC PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISIONAD DRESS
R
JOHN A. LAMBIE, COUNTY ENGINEE
CASSATT D. GRIFFIN,SUPT OF BUILDING LOCALITY v
FOR APPLICANT TO FILL, IN NEAREST
,PERMT FEES - CROSS ST -�
OWNER ; ! , P
ITEM NUMBER EACH FEE '
OUTLETS'- )) n $ $ MAIL
LIGHTS ECEPT/�_ SW. �-�• / 10 ! ADDRESS
LIGHTING FIXTURES. CITY TEL NO
LEC.RANGES L—CLO.DRYERS A— _ ELECTRICIAN
W AST H R HEATERS 3 .50 • O ADDRESS {r.G,/ w�"•i'�t
ELEC.SPACE HTRS DISHWASHERS CITY - - S TEL. NO. Iry
GARBAGE DISPOSERS AUTO.- STATE
WASHERS STA COOKING UNITS ,25 LICENSE NO.
MOTORS: OVER INC. H P - s DISTRICT NO. I GROUP ONEP CESSED BY
O— 1/2 I y/ .25 �
1/2- 2 .50 INSPECTION RECORD
2— 5 100
5 — 15 ISO
18— SO 250
50—200 5 00
SIGNS: NO TRANS -
NO.LAMPS ��gg ��44 p per,
SERVICE 0-800V 1.00 �L,� A j 6 14tg bj,"p
SERVICE OVER 600V Boo I
MISC.
WIRING PERMIT Too,
FIXTURE PERMIT Too
SUPPLEMENTARY PERMIT .50 -
TOTAL FEE $
1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS_ DATE INSPECTOR'SSIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT
ELECTRICAL WIRING. -
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGIBTEREDI AND/OR WIRING
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA, OR THAT 1 M E LEGAL -OWNER OF THE ABOVE
DESCRIBED RESIDENT/ R RTY. : POWER
SIGNATUREUTILITY CO.NOTIFIE51 - OAV
OF PERMITTE
FINAL - D
®P ATION ARTHUR C.VEIT,
CK Mp CASH SUPERVISING ELECTRICAL ENGINEER
fol,
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