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APPLICATION FOR ELECTR PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER rE 'L
UDING 'JBUILDING AND SAFETY DIVISION DDRESSJOHN A. LAMBIE. COUNTY ENGINEER WILLIAM A.JENSEN,SUF'T OF BUILDING OCALITY
FOR APPLICANT TO FILL IN NEAREST
PEMCT FEES
CROSS ST.
ITiIS NUMBER I EACH FEE OWNER
OUTLET 31 IS S / MAIL
LIGHTS neCHPT. .10 q ADDRESS
LIGHTING FIXTURES 10 9'V CITY TEL.NO.
ELEC,RANGES CLO.DRYERS ELECTRIC)IIA WATER HEATERS .DG ADDRESSEJ")23 E Broadway
ELEC.SPACE HTR[. DISHWASHERS CITYSan Ga f TEL. NO.GARBAGE DISPOSERS AUTO.- STATE
WASHERS STA.COOKING UNITS .25 LICENSE NO.MOTORS: OVER INC. H.P. DI T�f3,ICT GR UPI Z NE4C:]EO— Ih .25 1 -
VE— 2 .50 INSPECTION RECORD
2— 5 1.00 A°
O N
D— 15 1.50
15— DO 2.50
DO-200 5.00
SIGNS: No.TRANS.
NO.LAMPS
SERVICE 0-500V 1.00 D
SERVICE OVER SOOV 5.00
MISC.
WIRINGPERMIT 1.00 Q
FIXTURE PERMIT 1.00 O
SUPPLEMENTARY PERMIT .50
TOTAL FEE S6 va
1HEREBY 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 THY 1 AM PROPERLY REGI D/OR
LICENSED AS REQUIRED Y LCA ANGELES C FIT Y A TE OF FIXTURES
CALIFORNIA OR THAT f AM THE LE R ABOVE
DESCRIBED RE ENTIA ROPERTY. POWER
SIGNATURE ` UTILITY CO.NOTIFIED
OF PERMITTE
FINA
RTHUR C.OF iKAfQDATION $UPERVISIN6 ELECTRICAL ENGINEER
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LRC07 3 7 o OCT 2 LI �.
APPLICATION FOR ELECTRICAL PERMIT 'I
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING f3 %ff
BUILDING AND SAFETY DIVISION ADDRESSop QZL
JOHN A.LAMBIE, COUNTY ENGINEER .yam
WILLIAM A.JENSEN. SUPT OF BUILDING LOCALITY
FORAPPLICANTTO FILLIN NEAREST
c ROsS s
PERMIT FEES
OWNER 2E O
ITEM NUMBEq EACH Fe! MAIL
OUTLETS, P S ADDRESS
LIGHTS RECE . SW. .10
LIGHTING FIXTURES 10 CITY TE NO
ELEC. RANGES CLO.DRYERS ELECTRICIAN Sr
WATER HEATERS .50 ADDRE99
ELEC.SPACE HTRS. DISHWASHERS CITY TEL.NO.
GARBAGE DISPOSERS AUTO.. STATE
WASHERS STA.COOKING UNITS .25 LICENSE NO. C
MOTORS: OVER INC. N.P. DISTFFUCT 10. GROUP ZO E I P CESSED BY
0 — I/E .25 a"�' �.
Y. — 2 ,50 INSPECTION RECORD
2 - 1.00 1.00 d
5 — is 1.50 O
U
is — 5o 2.50 Ad
50 — 200 O
5.00 ~
V
W
SIGNS: NO TRAMPS N
NO. LAMPS
Z
SERVICE O.000V 1,00
SERVICE OVER SOOV 5.00
MISC.
WIRING PERMIT 1.00 Q-
FIXTURE PERMIT 1,00
SUPPLEMENTARY PERMIT ,50
TOTAL FEE
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR%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
LIC NEED AS REQUIRED BY LOB 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 PERMITTEE
FINA �
At ARTHUR C.VETT.
`/,CK MOO CASH
x SUPERVISING ELECTRICAL ENGINEER