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76A663-6E606 6-62 APPLICATION FOR ELECTRICAL PERMIT
r COUNTY OF LOS'ANGELES Rdp B
DEPARTMENT
UILD ERIG
G AND SAFETY DIVISION BUILDIN
BUILDING ADDRESS -9-24949 ' O W42'?" ZLtS Q .
JOHN A. LAMBIE. COUNTY ENGINEER /�
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY VW ��Q C •,
FOR APPLICANT TO FILL IN CROSS ST. ih L° 7� I t
RECEPT. TOTAL• NO. EACH FEE L,` + rt
OUTLETS FIRST 20 $.20 $ OWNER W eL Q+ 1�b
LIGHT MAIL
ADD'L ADDRESS
SWITCH. OVER 20 .10 ,
LIGHTING TOTAL FIRST 20 (O .20 CITY TEL.NO.
FIXTURES } OV DR 2O .10 ELECTRICIAN �{p e'c-f s jun
RANGES • CLO.DRYERS WTR.HTRS. 1.00 ADDRESS,110 I 0 LQ til+q oto S'4
GARB.DISP. STA.COOK aa
CITY ClQ TEL.NO.�r1 Q
DISHWASH. AUTO.-WASH. STATE
SPACE HTRS. STA.APP.(V=H.P.MAX.) .50 LICENSE NO.
MOTORS: OVER NOT OVER H.P. DISTRICT NO. GROUP ZONE OC,rESSED BY
O 1 '� 1.00 �vd� ♦=
1 s 1.50 1 1 1 14 1,4INSPECTION RECORD
a S 2.00 �'
S 15 2.50tj�} r
1s so 13.00 - 11/ vC: - a
SO too 5.00 Al' s O
SIGNS: NO.TRANS. __x
NO.LAMPS wlyv Q 1 O
SERVICE 0.60OV•NOT OVER 200A 1.00 ILA
SERVICE O.60OV.OVER 200 A. 2.00
SERVICE OVER 600V 5.00
MISC.
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE $ p
Aj
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE ..INSPECT R'S SIGNATURE
/41
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR pp v
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES 6IIy af.
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE �,�/
DESCRIBED RESIDENTI PROPERTY. r a POWER kf
SIGNATURE �i �/ UTILITY CO.NOTIFIED
OF PERMITTE /�" ,� .11:1 `L/� f!% _
FINAL �.
VALIDAT1 ARTHUR C. VEIT
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
Li► 0 2 1 0 7 Q OCT 31 2 0 8.10-