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76A663-CE806 8-62 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF.COUNTY-ENGINEER_ BUILDING '�+.� Z� �ryJ �� r'o.•r
,BUILDING AND SAFETY DIVISION r ADDRESS / -
JOHN A. LAMBIE, COUNTY ENGINEER `
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST: bR✓N�`3 �! .
RECEPT.ZZ. TOTAL NO. EACH 'FEE
OUTLETS FIRST 20 $2O $ - 6 OWNER .Jc/rte f ev h;'
LIGHT /� r
ADO'L ADDRESS! X700 - �' a q.,+�'<e
SWITCH•/,v �_f_'_ OVER 20,_C .. .10 ..7,6
LIGHTING &/,
TOTAL FIRST 20 .20 CITY /7 A/54-v, I. TEL.NO.
� �
FIXTURES ADD'L c1D ELECTRICIAN �R F'/PC: �'
OVER 2O
RANGES CLO.DRYERS WTR.EITRS. 1.00 ADDRESS 'YO3 E ffrORf/w't
GARB.DISP. STA.COOK - / - �,�yf9 -
CITY 1-y.kArlt TEL.NO. ,7is',.LL ' �
DISHWASH. AUTO.-WASH. STATE -
SPACE HTRS. -A_STA.APP.(Vs H.P.MAX.) .50 LICENSE NO. C''
MOTORS+ OVER NOT OVER H.P. DISIECT GROG Z E, P . SSED BY
O 1 1.00
1 5 1.so INSPECTION RECO D'
s 8 2.00 7 - Zjrr L C' A
.8 15 2.50
15 So 5:00 ?
a
50 100 5.00 O
U
'NO.TRANS.
SIGNSs NO.LAMPS 0
SERVICE 0.600•V-Nos OVER 200A 1.00 W
SERVICE 0-600V-OVER 200'A. 2.00
H
SERVICE OVER 600V 5.00 ?
MISC.
PERMIT 16SUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE $/� O
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO.COMPLY CONDUIT .;1 ♦.
WITH ALL•COUNTY ORDINANCES AND. STATE LAWS REGULATING
ELECTRICAL WIRING, WIRING l � {
1 HEREBY CERTIFY THAT I 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 THE ABOVE ,
DESCRIBED BESIDE N L PROPERTY. POWER
SIGNATLIRE ..4 UTILITY CO.NOTIFIED r 3016� .
OF PERMITTE 1�p
FINAL -7
LIDATION ARTHUR•C. VEIT
oc�
MO CASH
SUPERVISING ELECTRICAL ENGINEER
Lr1l,D 3 7 0 3 DEC 19 2 D 13.00-