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HomeMy Public PortalAbout5940 OAK AVE_Electrical__ APPLICATION FOR ELECTRI PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEEReUILDING BUILDING AND SAFETY DIVISION ADDRESS (/ JOHN A. LAMBIE, COUNTY ENGINEER CASSATT D. GRIFFIN.8UPT OF BUILDING LOCALITY J FOR APPLICANT TO FILL IN NEAREST ilL-ia• �AS P,n'� = CROSS ST. ITEM ri NUMBER I EACH FEE OWNER i lJ OUTL $ $ MAIL 1#45 L1NAS A�, LIGHTS RECEPT. W S . 10 ADDRESS aQ �{ LIGHTING FIXTURES10 O CITY .L TEL.NO. ELEC.RANGES CLO.DRYERS ELECTRICIAN WATER HEATERS .50 ADDRESS u ELEC.SPACE HTRS. DISHWASHERS �,{� CITY TEL. N GY3 GARBAGE DISPOSERS AUTO.- STATE WASHERS STA.COOKING UNITS .25 .LICENSE NO. / 0 MOTORS: OVER INC. H.P. DISTL GROUP NE 0— 1/2 .2 s J I Q Z 1/2— 2 .so WSPECTION RECORD 2— s 1.00 r 1s— so 2.50 I! so—zoo 5.00 ._� �, � �..s.�'_y r s+-.V.'-y/fes- c-�Y�...,�"i...�S.• / SIGNS: NO.TRANS. a NO.LAMPS I SERVICE 0-600N It 1.00 SERVICE OVER 600V s.00 MISC. 7 WIRING PERMIT 1.00 CQ FIXTURE PERMIT 1.00 1[Ott SUPPLEMENTARY PERMIT .50 ' TOTAL FEE $ Q 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS f D T6 INSPECTOR'S SIGNATURE V AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY II�� WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT ? ELECTRICAL WIRING. - 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR WIRING LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. POWER SIGNATURE UTILITY CO.NOTIFIED OF PERMI FINA ®rI ON ARTHUR C.VETT, (` CK NoO CASH SUPERVISING ELECTRICAL ENGINEER 5 2 7 TMV ?p 2 D 3 5.6 0 . n� 76AS08 CE808 10 62 APPLICATION FOR ELECTRI AL PERM T COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS �- �.� JOHN A LAMBIE COUNTY ENGINEER WILLIAM A JENSEN SUP T OF BUILDING LOCALITY NEAREST FO APPLICANTO FI IN CROSS ST Rsc�r TOTAL No SACH Pee OUTLETS FIRST 20 $20111 � OWNER LIGHT ' MAIL w OF swlrcH ADD{t� ADDRESS Q OVER 2O t0 LIGHTING TOTAL FIRST 20 20 CITY — TEL NO FIXTURES ADD L f0 ELECTRICIAN ovER 20 RANGES CLO DRYERS WTR NIRS 100 ADDRESS OARS DIBP GTA COOK CITY TEL 6 DISHWASH AUTO WASH STATE SPACE NTRS STA APP (A N P MAX) so LICENSE NO -7 C �V MOTORBe OVER NOT OVER NP DIST)2 'T NO 6UP ZONE P CESSED By O 1 1100 y t s ISO INSPECTION RE99RD s s 200 s is S s0 1S so Soo SO foo Soo BIGNSI NO TRANS No LAMPS SERVICE O SOOV NOT oveR YOGA 100 SERVICE O SOOV OVER 200 A 200 SERVICE OVER SOOV Soo MISC PERMIT ISSUING FEE 200 w SUPPLEMENTARY PERMIT ISSUING FEE 100 TOTAL FEE i O I I SHEBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INBPKCTOR S SlamrUlm AND STATE THAT THE ABOVE 18 CORRECT AND AGREE To COMPLY CONDUIT WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ELECTRICAL WIRING WIRING I HERESY cowriFY THAT 1 AM PROPERLY RK01BiERED AND/OR LICENSED AS RKOUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVK DESCRIBED RESIDENTIAL PROPERTY POWER SIGNATURE UTILITY CO NOTIFIED OF PBRMITT6 FINAL CK 1,MO CASH SUPERVISINd ELECTRICAL ENGINEER L&O 2 0 1 APR, �, 2 D 2.40- 'l;. CIT 76A067-C1806 4-60 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER FADDRESS BUILDING AND SAFETY DIVISION JOHN A.LAMBIE, COUNTY ENGINEERWILLIAM A. JENSEN, SUP'TOF BUILDING FOR APPLICANT TO FILL IN NEARESST CROSS T Al/,5 PERMIT FEES lk4 OWNER1TEM NUMBER EACH FEE OUTLETS � s sADDRESS 4 SL16HT8 RECEP BW. �7 .10 LIGHTING FIXTURES CITY `� G ! TE NO.f0ELEC. RANGES CLO. DRYERS ELECTRICI�IN2ALI- ,C -4�q WATER HEATERS .BO ADDRESS ! 6 /V SELEC.SPACE HTRS. DISHWASHERS CITY L-• 6 TEL.NO. GARBAGE DISPOSERS AUTO.- 'STATE /� LICENSE NO. / / WASHERS STA. COOKING UNITS .2B MOTORS: OVER INC. H.P. DISTRJT N OUP ONE. PR CE D Y O — '/2 .25 0 'i: — 2 .50 I RECORD ,ter 2 5 1.00 a 5 15 1.50 7 7 0 15 50 2.50 w O BO 200 5.00 qi... _ ... _ - 1-- NO NO TRANS. _ w r , SIGNS: d. NO. LAMPS v> � Z SERVICE O.800Vi.00elL SERVICE OVER 800V 5.00 MISC. WIRING PERMIT 1.00 �4-O FIXTURE PERMIT 1.00 SUPPLEMENTARY PERMIT .50 TOTAL FEE S Z 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT ELECTRICAL WIRING. WIRING I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES NTY AND STATE OF FIXTURES , CALIFORNIA OR Tli M T E L ER OF THEfB DESCRIBED RESIBEf-jT POWER SIGNATURE!/// UTILITY CO. NOTIFIED jG-" ; OF PERMITTE FINAL A (DATION ARTHUR C.VETT. ' CK MO CASH SUPERVISING ELECTRICAL ENGINEER l .'�4 D i 0 UC i '7 76A663 CE606 11/70 APPLICATION FOR ELECTRICAL PERMIT L1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING �� O BUILDING AND SAFETY DIVISION ADDRESS COLEMAN W JEN INS UP NT N UNT BUILDING LOCALITY FOR APPLICANT TO FILL IN CROSS ST S [J�Ir7 OUTLETS O EA H FEE L� OWNER! /aL RECEPT_J_ $ $ MAIL �+ LIGHT TOTAL FIRST 20 25 /�� ADDRESS V SWITCH-9---.-1 �— OVER 20 10CITY TEL NO PLAN CHECK LIGHTING1 FIRST 20 0 1 APPLICANT ) TOTAL FIXTURES r OVER 20 t0 ADDRESS APPLIANCES CITY TEL NO PERMIT RANGE DRYER_WTR HTR APPLICANTA/64=0 STA COOK DI SP F A U ADDRESS S773 ve_1.!/4CE' eLl/D. SPACE HTR AIR COND CITY 4,A , TEL NO -,dW CLOTHES WASH DISHWASH LICENSE NO 1,94,96g CLASS G-�O FAN OTHER 100 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY MOTORS TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND HEATERS ETC NP KW KVA ELECTRICAL WIRING SIZE & TYPE OVER TO 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR 0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF AND INTEND TO >_ 1 - 10 300 R661DE IN THE ABOVE +DESCRIBED RES IAL PROPERTY OL 10 - 50 500 OF PERMSIGNATURITTEO 7-_ '� may V OC 50 - 100 1000 ICTN CLASS PONE PRO E Y O 100 - 500 1500 DISTRdool 10/ 7— 4 SIGN GAS SIGN AND ONE CIRCUIT 500 NOTES h Z TUBE OR MARQUEE ADDITIONAL CIRCUITS 100 SERVICENOTOVER600 VOLTS OR 200AMP 300 SERVICE OVER 600 VOLTS OR200AMP 1000 APPROVALS DATE INSPECTOR 9 SIGNATURE TEMP POWER POLE TEMPSERVICE POLE &APPURTENANCES 500 TEMP LIGHT OR RECEPT SYSTEM 300 UNDERSLAB WORK ROUGH CONDIUT WIRING It FIXTUR POWER AUTHORIZED PERMIT FEE (SUB TOTAL) UTILITY CO NOTIFIED PLAN CHECK FEE kc Of FINAL PERMIT ISSUING FEE 300 3 JOSEPH C ROONAN TOTAL FEE 00 SUPERVISING ELECTRI)IL ENGINEER PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATIONCKM O CASH 10'3 9 4 7 Jai 13 o 7.0 OM SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 1 -T--en pre_ C' - A . '° °'°s°�'°'" APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER )1DDRESS o BUILDING AND SAFETY DIVISION OAK LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST FRECEP ,�� TS ° FE OWNER 0 FIRM NA MAIL T TALFIRST 20 2SOv ADDRESS OVER 20 CITY TEL NO ( 10 ! PLAN CHECK FIRST 20 28 APPLICANT TOTAL OVER 20 10 •J'f /o ADDRESS RESIDENTIAL APPLIANCES L CITY TEL NO PERMIT0At C RANGE DRYER_WTR HTR APPLICANT �� STA COOK DISP F A U ADDRESS 2_ 5# Vle SPACE HTR AIR COND CITY S TEL NO ,3 3 CLOTHES WASH DISHWA8H RA FNUMBER V,3CLASS C� FAN OTHER 100 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY MOTORS TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND HEATERS ETC HP KW KVA ELECTRICAL WIRING SIZE 6 TYPE OVER TO I HEREBY CERTIFY T T ZPPOP,6RLEOISTERED AND/OR 0 - 1 100 LICENSED A8 REQUIR BY TY AND STATE OF CALIFORNIA OR TNA I R OF THE ABOVE I - 10 800 DESCRIBED RES PRp C7 10 - 50 600 PERMITEE SIGNATU C2 SO - 100 1000 DISTRI NO SSED BY � 100 - 800 1000 ��O ' g SI ON GAS SIGN AND ONE CIRCUIT 500 APPROVALS DATE INlE 8810NATURE TUBE OR MARQUEE ADDITIONAL CIRCUITS 100 TEMP POWER POLE SERVI CENOT OVER 600 VOLTS OR 200 AMP 800 UNDERSLAS WORK SERVI CEOVER 600 VOLTS OR 200 AMP 1000 ROUGH CONDUIT TEMPSERVICE POLE &APPURTENANCES 500 WIRING TEMP LIGHT OR RECEPT SYSTEM 800 FIXTURES S POWER AUTHORIZED UTILITY CO NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES PLAN CHECK FEE PERMIT ISSUING FEE 800 TOTAL FEE o PLAN CHECK VALIDATION CK M D CASH PERMIT VALIDATION CK M 0 CASH 14 59g.'tNNf 13 2 1 8.7 0 d* SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE 7eweee cseOG ,Gne APPLICATIO�FELECTRil& PERMIT �I COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER TNEAREST BUILDING AND SAFETY DIVISIONITY FOR APPLICANT TO FILL IN CROSS ST 40 r OUTLETS NO RACHI FE OWNER OR FIRM NAME ! RECEPT_ 5 $ MAIL LIGHT TOTAL FIRST 20 29 ADDRESS OVER 20 CITY TEL NO SWITCH 10 PLAN CHECK LIGHTING FIRST 20 25 APPLICANT TOTAL FIXTURES OVER 20 t0 ADDRESS RESIDENTIAL APPLIANCES CITY TEL NO RANGE DRYER_WTR HTR APPLICANT STA COOK DISP F A U ADDRESS a, Z SPACE HTR AIR COND CIIITY TEL NO CLOTHES WASH OISHWASH REG�NUMBER p 3 L CLASS d=-/o, FAN '- FAN OTHER 100 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY MOTORS TRANSFORMERS RATING WIT H ITN ALL COUNTY ORDINANCES AND STATE LAWS REGULATING IND HEATERS ETC HP KW KVA ELECTRICAL WIRING SIZE & TYPE OVER TO 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR 0 - I t00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT-1 AM THE LEGAL OWNER OF THE ABOVE 4 1 - 10 DESCRIBED RESIDENTIAL ROPERTY -- w 'PERMITEE 10 - 50 500 SIGNATUR 50 - 100 1000 DISTRICT NO SED BY WCs C1. 100 - 500 1500 % z SIGN GAS SIGN AND ONE CIRCUIT 500 APPROVAL$ DATE INSPE96 8SIGNATURE TUBE OR MARQUEE ADDITIONAL CIRCUITS 100 TEMP POWER POLE SERVICENOTOVER 600 VOLTS OR 200 AMP 800 UNDERSLAS WORK SERVI CEOVER 600 VOLTS OR 200 AMP 1000 ROUGH CONDUIT TEMPSERVICE POLE &APPURTENANCES 500 WIRING TEMP LIGHT OR RECEPT SYSTEM 800 FIXTURES POWER AUTHORIZED UTILITY CO NOTIFIED FINAL �7 PERMIT FEE (SUB TOTAL) NOTES PLAN CHECK FEE , PERMIT ISSUING FEE 800 TOTAL FEE PLAN CHECK VALIDATION CK M D CASH PERMIT VALIDATION M o CASH 51 "Imaz 18.0 0 SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE v WORKER S COMPENSATION DECLARATION 260019 DPW(12 91) APPLICATION FOR ELECTRICAL PERMIT 1 hereby affirrirthat I have e"certiAc t\4 of consent to self insure 78A8lD or a certificate of Worker a Compenihoratlnsurance or a certified COUNTY OF LOS ANGELES DEPT OF PUBLIC WORKS BUILDING AND SAFETY DIV copy thersoflSec 38Q0 Lab C) Policy No V:j 7 Company 5bq-4e—F&df41 FOR APPLICANT TO RLL IN JOB �j�� q�/� � E] Certified 4:64:6.e'Certified copy Is hereby furnished New Residential Bldgs &Pools NO EACH FEE LOCALITY ❑ 1&2 Family Sq Ft — $ $ Certified copy,is filed with the county budding Inspection _ NEAREST dopa me 01 Multifamily Sq Ft CROSS ST Data A + Applicant Residential Swimming Pools ASSESSOR MAP BOOK � PAQE OwpPARCEL G CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Ree I Light S. �2— FFOR I MENAME S a, COMPENSATION INSURANCE (This section need not be completed If the work Involved by the First CRESS permit is for one hundred dollars($100)or leas) Total No Additional I certify that in the performance of the work for which this permit CITY Tel No is issued I shall not employ any person in any manner so as to PLAN CHECK become subject to the Workers Compensation Laws Llghbng Fixtures First ZO APPLICANT Total No Additional ADDRESS Date Applicant RESIDENTIAL APPLIANCES NOT OVER 3 HP NOTICE TO APPLICANT If after making this Certificate of CITY Tel No Exemption you should become subject to the Workers Compensation OTHER APPLIANCES NOT OVER 3 HP provisions of the Labor Code you must forthwith comply with suchP RLICANT provisions or this permit shall be deemed revoked Power Apparatus&Large Appliances LICENSED CONTRACTORS DECLARATION Size&Type HP KW KVA or KVAR ADDRESS I'hereby affirm that I Am licensed under provisions of Chapter 9 Over 3 to 10 Incl (commencing with Section 7000)of Division 3 of the Business and CITY — Tel No Professions Code and my license is In full force and effect Over 10 to 50 Incl G/ >, Over 50 to 100 Incl REONNUMBER ~d aj (L Over 1 00 License Number DISTRICT NO SSED BY'7(,vy Lic Class V Services Swbd MCC&Panelboards est,�� Q Contractor GCJen ���OCS-L& Data 0 399 Amp Under 600 VDATE 0 r—rc ❑ I am exempt under Sec 400 1000 Amp Under 500 V �` VALIDATION W Over 1000 Amp or Over 800 V FINIAL a B&P C for this reason BRANCH CIRCUIT FEES BY co Date 15A or 20A 120V Lighting or Recept 1 To 10 Branch Circuits R�enature�_ 11 To 40 Branch Grcuds cuits ❑ Exemption for Reg Maint Elect 15A 20A 208V To 277V Lighhtin Bir Branch 2 SINGLE FAMILY Temp Power Pole&Appurtenances ACLT i HOME OWNER BUILDER DECLARATION Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor a License Law 3303 49 80 for the following reason(Section 7031 5 Business and Professions Additional Sign Branch Circuits Code) 1 ITEMS ❑ 1 as owner of the property will do the work and the structure Misc Conduits&Conductors PTAL 49.80 is not intended or offered for sale(Section 7044 Business Other(See Complete Fee Schedule) and Professions Code) , CHECK 49.80 CONSTRUCTION LENDING AGENCY GHph(GE aO I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued(Sec 3097 PERMIT FEE (Sub Total) Civ C) PLAN CHECKING FEE 00OD-0001 11/ 994 Lender a Name ?(441 1 FM12 u0 PERMIT ISSUING FEE (p Lender a Address I certify that I have read this application and under penally of puqury state TOTAL FEEso pie that the above information is correct I agree to comply with all County ordinances and State laws regulating Electrical wiring and hereby authorize representatives of this County to enter upon the above mentioned property for inspection Purposes SEE REVERSE FOR EXPLANATORY LANGUAGE )d i I)I—q 4- ~TURE OPPERMITrEE DATE I WORKERS COMPENSATION DECLARATION B3 CE408G (2 80) APPLICATION FOR ELECTRICAL PERMIT E8 I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES T BUILDING AND SAFETY insure or a certificate of Workers Compensation Insurance or a certified copy thereof(Sec 3800 Lab C) FOR APPLICANT TO FILL IN JOB • • -"�� Policy N Company New Residential Bldgs &Pools EACH NO FEE ADDRESS x/111) a �f//Ce Certified copy is hereby furnished 1&2 Family Sq Ft $ — $ LOCALITY i ` L Multifamily Sq Ft CertifIod copy>8 filed with the m co y building inspection CROSS S7 1! departmentResidential Swimming Pools OWNER OR /�j�� 1 is Date�iR�Applicant #Ad '� FIRM NAME I�tOriLL .s!/� pp Outlets Rec._Lig Sw MAIL First 20 ADDRESS CERTIFICATE OF EXEMPTION FROMWORKERS Total No Additional CITY el No } COMPENSATION INSURANCE d PLAN CHECK (This section need not be completed if the Work involved APPLICANT Bred dollars ($100) or less) Lighting Fixtures First 20 by the permit >s for one hundred ADDRESS Total No Additional 0 I certify that in the performance of the work for which this Fixed Appliances Not Over 1 HP CITY I No 41 permit is issued i shall not employ any person in any manner PERMIT so as to become subject to the Workers Compensation Laws Range_Heater D W _ APPLICANTOW. Oven — Dryer_W M ADDRESS Tel N� . A#/,f 2- a Date d'� Applicant Top _FAU _W H _ IF - Hood _Fan _Other_ CITY �� �� 4•.C? NOTICE TO APPLICANT If afte king this Certificate of Disp _Room Air Condi_ CENSE R �r� p Exemption you should become ubject to the Workers REG NUMBER 6 / Class o Compensation provisions of the Labor Code you must forth Power Apparatus&Large Appliances DISTRICT NO PROC SED BY with comply with such provisions or this permit shall be Size&Type HP KW KVA or KVA deemed revoked Up to 1 Incl � Over 1 to 10 Incl FINAL LICENSED CONTRACTORS DECLARATION DATE �/ VALIDATION Over 10 to 50 Incl 1 I hereby affirm that I am licensed under provisions of Chapter Over 50 to 100 Inc FINAL 9 (commencing with Section 7000)of Division 3 of the Bust Over 100 BY ` 6 ness and Professions Code and my license is in full force and effect Services License Num Lic Class 0.200 Amp Under 600 V 201 1000 Amp Under 600 V 0 o Y 7 / 3 ""�ontrilct Date S+�-. - Over 1000 Amp or Over 600 V �� HOME OWN R BUILDER DECLARATION Temp Power Pole&Appurtenances , I hereby affirm that I am exempt from the Contractors Sign with One Branch Circuit License Law for the following reason (Section 7031 5 Busi Additional Sign Branch Circuits 23838 A ness and Professions Code) # a a a a a 2 Mist Conduits&Conductors I as owner of the property will do the work and the Other(See Complete Fee Schedule)— 2 a a 2 7 structure is not intended or offered for sale (Section 7044 Business and Professions Code) CONSTRUCTION LENDING AGENCY a a'a 1 2 7 0 5 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is PERMIT FEE (Sub Total) f W 04.30-82 issued(Sec 3097 Civ C) Lender a Name PLAN CHECKING FEE (One Fourth Permit Fee) ' Lender s Address PERMIT ISSUING FEE �D I certify that I have read this application and state that the TOTAL FEE i above information is correct I agree to comply with all County s ordinances and State laws regulating Electrical wiring and hereby authorize representatives of this County to enter upon theAbon maelfione rorty for inspection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE 3a gay Signature of Permitte Date