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DOS-9A if•SS APPLICATION FOR ELECTRIC 'PERMIT' 1
OS-SA
DIMON OF BUDDING AND SAFETY
Depcm mnt Of County Engineer BUILDING
County of Los Angeles ADDRESS
JOHN A.LAMBIE.COUNTY ENGINEER A /J
CASSATT D.GRIFFIN.SUPT OF BUILDING LOCALITY e—
PEDAPPLICANT F��STO FILL 1N NEARCROS S r
CROSS ST.
NUMBER OWNER
LIGHT OUTLETS MAIL
RECEPTACLES ADDRESS
WALL SWITCHES FEE CITY• TEL.NO
TOTAL OUTLETS ® 8¢ $
ELECTRICIAN " -
ELEC.RANGES 28
ADDRESS
C.HEATERS 28
KW EA CITY TEL.NO.
STATE
FIXTURES g LICENSE NO.
MOTORS KDISTRICT NO. GROUPONE READY FOR IRSPECYIOR
NUMBER HORSEPOWER PER fJCa
NEW MVD. HP OVER INC. EACH
Yz $ INSPECTIO RECORD
a LESS .23
lie 2 .30
2 8 1.00
3 18 1.30
13 30 2.80
80 200 3.00
MISC.
NO.SIGNS NO.TRANS.
NO.SIGNS NO. LAMPS
FOR EACH PERMIT: .
WIRING $1.00
FIXTURES $1.00
SUPPLEMENTARY •Sp1 APPROVALS
TOTAL FEE $ / 10191 DATE INSPE OR•S SIGNATURE
6 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT-
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING
ELECTRICAL WIRING.
i HEREBY CERTIFY THAT I AN PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE 'EGA NER OF THE ABOVE POWER
DESCRIBED RESIDENT PER
SIGNATURE UTILITY CO.NOTIFIED
OF PIERIAITTEE FINAL
JOHN A.LAMBIE.COUNTY ENGINEER VALUATION ARTHUR C.VEIT.CHIEF ELECT.INSPECTOR
CK NO CASH
i��7 4 3 7 jum26 2 1 .00 10