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76AG63-CES061-67 APPLICATIO FOR E.LEC RICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER FEA
G �
BUILDING AND SAFETY DIVISION W r`1/
JOHN A. LAMBIE, COUNTY ENGINEER e�xA I G �, r
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING. Y !i/ 'J
FOR APPLICANT TO FILL IN .RECEPT. ( TOTAL NO. EACH FEE �/1 L/
LIGHT
OUTLETS FIRST 20 [20 8 MWNER_/V FI
SWITCH AIL
ADD'L �J ADDRESS
OVER 20 C/
TOTAL FIRST 20 /Q d CITY- TEL.NO..
LIGHTING 1 FIXTURES
FIXTURES J( ADD'L CONTRACTOROVER 20 RANGES DRYERS WTR.HTRS. ADDRE88GARB.DISP. STA.COOK cITY L /r TEL.No. ;LP4EMD
DISHWASH. AUTO.-WASH. STATE [�6SPACE HTRB. BTA. APPL.
LICENSE NO. J
MOTORss OVER NOT OVER H.T. DISTRICT GROUP ZONE
0 1 1.00
1 3 1.50 INSPECTION RECORD
3. S 2.00 Li ;
8 15 2.50
15 SO 3.00
50 100 5.00 V
SIGNS. NO.TRANS. 0
NO.LAMPS 0
SERVICE O.SOOV-NOT OVER 200A 1.00 IL
d
SERVICE O-SOOV-OVER 200 A. 2.00 Z
SERVICE OVER 600V 5.00
OTHER (SEE COMPLETE FEE SCHEDULE)
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 APPROVALS DATE INSPECTOR'S SIGNATURE
TOTAL FEE f 9
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION UNDERSLAS WORK
AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY ROUGH CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR '
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF,AND INTEND TO POWER 1�l
RESIDE IN,THE ABO DESC ISED RE ENTIAk PROPERTY. /y
SIGNATURE UTILITY CO..NOTIFIED
OF PERMITTEE
FINAL
VALIDATION .1 SEPH C. ROOHAN
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
02
0615% Su1.3 2D 10.10N
78A888-CE8081-67 APPLICATION FOR ELECTRIC L PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER J� G�
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING. LOCALITY �`
FOR APPLICANT TO FILL IN
NEAREST
ROSSS T. OS /�/�lFD
RECEPT. TOTAL No. EACH FEE
l OUTLETS FIRST 20 x.20 $ OWNER C
LIGHT J MAIL _
SWITCH ADO'L 10 ADDRESS
OVER 20
TOTAL FIRST 20 .20 CITY TEL.NO.
LIGHTING 1_____ _4
FIXTURES
FIXTURES ADD'L CONTRACTOR
OVER 20 .10
RANGES DRYERS WTR.HTRS. 1.00 ADDRESS t �r
GARB.DISP. BTA.COOK CITY TEL.NO. Gds 3( LS
DISHWASH. AUTO.-WASH. STATE / 1j
SPACE HTRS. STA. APPL. .50 LICENSE NO. [ 1/
MOTORS: OVER NOT OVER H.P. DISTRICT NO. J G ZONE P
O 1 1.00
1. s 1:5o INSPECTION REC RD
s a 2.00
8 15 2.50
15 50 1 13.00 d
50 100 5.00 0
SIGNS:
NO.TRANS. f OL
NO.LAMPS I0
SERVICE O-SOOV-Nor OVER 200A 1.00 W
SERVICE O-SOOV-OvER.200 A. 2.00 y
SERVICE OVER SOOV 5.00 ?
OTHER (SEE COMPLETE FEE SCHEDULE)
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 APPRWALS DATE INBPECiOR'8 SIGNATURE
TOTAL FEE S
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION UNDERSLAB WORK
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ROUGH CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL*IRING. WIRING
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM,THE LEGAL O NER OF,AND INTEND TO POWER
RESIDE IN,THE ABOVE j3ESCRIBED RESLOdNTIAL PROPVRTY.
SIGNATUREUTILITY CO.NOTIFIED �i V ✓ s
OF PERMITTE
FINAL Z� _ P
',�LIDATION JOSEPH C. ROOHAN
/ CyC/ MO CASH SUPERVISING ELECTRICAL ENGINEER
L 0 7 0 .9 SEP 1 8 2 0 3.0 ON �