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76ASSS-CESCS-H-WAPPLICATION FOR ELECTRIC PERMIT1
COUNTY OF LOS XWELES
DEPARTMENT OF COUNTY ENGINEER ABUILDING
DDRESS I +p
BU�IILCDING AND SAFETY� DDIMON
CASSAiT A Gs>FF�icO'sve ol11m�.idinQ eocpLlTY
NEAREST
FOR APPLICANT T TO ILL IN CROSS ST.
PEMWEMS
ITEM NUMBER EACH FEEOWNER
' OUTLETMAIL
�' $ 10 $ ( ADDRESS
LIGHTS RECEPT. BW.
LIGHTING FIXTURES � IO CITY VOL.NO.
ELEC.RANGES CLO.DRYERS ELECTRICIAN'
WATER H A T E R S 1 .50 ADDRESS p
ELEC.SPACE HTRS. f�SHWASHERB ,
GARBAGE DISPOSERS AUTO._ CITY TEL.NO. �
WASHERS STA.COOKING UNITS .25 J STATE
_ LICENSE NO.
MOTORS: OVER INC. H.P.
O— I/a 1 '.2.5 5 DIST RI N GROUP I VNE
/ READY FOR INSPECTION
I/2 — 2 .50 �J .L
2 — 5 1.00 INSPECTION RECORD
I
s — is 1.50
15 ,— SO 2.50
50— 200 s.0o �- ; /I l.�L
I
SIGNS: NO.TRANS.
NO.LAMPS �' .
r7l I.!
SERVICE 0-600V 1.00
SERVICE OVER 600V 5.00 y-
. r
' ` „r'.�=<�•'=.=moi,rjk -z 7 / r.!'✓�
WIRING PERMIT 1.00 ( t
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT .SO' I .
TOTAL FEE S APPROVALS
I HEREBY ACKNOWLEDGE THAT I HAVE READ"I APPLICATION DATE ,INSPECTOR'S.SIGNATURE
AND STATE THAT THE.ABOVE IS CORRECT. AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES C TY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AN THE LEGAL. N R OF HE ABOVE POWER -
DESCRIBED RESIDENT ROP
SIGNATURE ( 4 0% 1UTILITY CO.NOTIFIED A'?L,'-,fir' , 11•,n1.9-2
OF PERMITTE -
FINAL - J
ATIO
C MO sPERvs HELE
CASH CTRICAL EN0N=R
�ACO 4 7 0 PUR, SEP 11 2 A 13.45 190