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APPLICATION FOirFll: CTRICA PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER e-�• 1
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROss ST.
RECEPT. TOTAL N0. EACH FEE I -
OUTLETS FIRST 20 S.20 $ OWNER
LIGHT D MAIL
ADO'L f0 ADDRESS (p
SWITCH. OVER 20
LIGHTING TOTAL FIRST 20 .20 CITY TEL.NO DO
FIXTURES } AOD'L 10 ELECTRICIAN
OVER 20
RANGES CLO.DRYERS WTR.HTRB. 1.00 ADDRESS 9
GARB.DISP. BTA.COOK
CITY TEL.NO..I►'���ii
i "'ji
DISHWASH. AUTO.-WASH. STATE
SPACE HTRB. BTA.APP.(ya X.P.MAX.) .50
LICENSE NO`
MOTORSI OVER NOT OVER H.P. DISFICy'r<ANO./ GR UP P ESSED BY
O • i 1.00 U �f
1 s 1.50 INSPECTION, RECORD
�I
s B $.00 y+
S
is 2.50 ' �-' / C
O
is so s.00 U
m
so ioo 5.00 O
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SIGNSI NO.TRANS. U
.NO.LAMPS
d
SERVICE 0.60OV-NOT OVER 200A 1.00 Z_
SERVICE•O-SOOV-OVER 200 A.. 2.00
SERVICE OVER 600V 5.00
MISC,
PERMIT ISSUING FEE 2.00
BUPPLEMENTAI3Y PERMIT ISSUING FEE. 1.00
TOTAL FEE
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY CONDUIT �. ����
WITH ALL•COUNTY ORDINANCES AND STATE LAWS REGULATI(iG ,v '
ELECTRICAL WIRING. WIRING
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED.AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THATHE L GAL OWNER OF THE ABOVE
DESCRIBED RESIDEN A E_RT POWER
SIGNATURE Wl I UTILITY CO.NOTIFIED //' 7 /•r
OF PERMITTE FINAL e',ry V�' ��'s�✓ �:.L-�
CK�LIDATION ARTHUR C. VEIT
MO CASH SUPERVISING ELECTRICAL ENGINEER
UJUO 5 0 4 4% OCT 2 2 D 3.6 0-
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IAG63-CR00010.61 APPLICATION FOR ELS� TRIC-AL P MIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER . BUILDING dy
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER ,
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
1 T E M NO. I EACH FEE
OUTLETS: (FIRST 20) *.20 S OWNER
LIGHTS RECEPT. SW. MAIL
OUTLETS: (ADD'L UNITS) 10 .y ADDRESS
LIGHTS RECEPT. SW. !�
LIGHTING FIXTURES: (FIRST 20) .20 CITY TEL.
LIGHTING FIXTURES: (ADDITIONAL) .10 ELECTRICI
RANGES CLO.DRYERS WTI.HTRS. 1.00 ADDRESS
GARB.DISP. STA.COOK
CITY TEL.NO.
DISHWASH.. AUTO.-WASH. ST
SPACE HTRS.. STA.APP.(yE H.P.MAX.) i. .50 LICENSE NO. y�
MOTORS: OVER NOT OVER H.P. DRICCI�D. GP N P E D- Y
O 1 1.00 ,� �f
1 a 1.50 RiSPECTION RECORD
a s 2.00Aevgp r O
8 15 2.50 f ✓def l: w�#J.rl:^° .,Rr I { �1 Ads- dad
15 50 9.00 64w Z_
s0 100 5.00 A
W
C
SIGNS: NO.TRANS:
NO.LAMPS Z
SERVICE 0.600V.NOT OVER 200A 1.00
SERVICE 0-60OV-OVER 200 A. 2.00
SERVICE OVER 600V 5.00
MISC.
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP LIGATION APPROVALS 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 ',1 �r
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED 'S REO EDB WS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR AT 1 LEGAL OWNER OF THE ABOVE
DESCRIBED REBID OPE POWER -
SIGNATURE UTILITY CO.NOTIFIEDOTHUR
2 A.••
OF PERM'TT E FINAL LIDATION VETT
CK MO CASH SUPERVISING ELECTRICAL.ENGINEER
5 7 6 18 2 D 1 3.10N