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APPLICATION FOR ELECTRIC PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUIlO1NG
BUILDING AND SAFETY DIVISION gpDREss
JOHN A. LAMBIE, COUNTY ENGINEER /
WILLIAM A.JENSEN.SUPT OF BUILDING [LOCALITY
y/ �/I'�,(, c
FOR APPLICANT TO FILL IN NEAREST
PERMIT FEES CROSS ST.
ITEMNUMBER EACH FEE OWNER
OUTLETS: $ $ MAIL
LIGHTS RECEPT. 8W.
f0 ADDRESS
LIGHTING FIXTURES 10 CITY TEL.NO.
ELEC.RANGES CLO.O ERS ELECTRICIAN
WATER HEATERS .50 ADDRESS {./
ELEC.5PACE HTRS. DISHWASHERS CITY 1 TEL. NO.
67/
GARBAGE D15P05ERS AUTO.
STATE
WASHERS STA.COOKING UNITS .25 LICENSE NO. V j-
MOTORS, OVER INC. H.P. DISTRI A NO. GROUP ZONE I[tPmucESSED Y
O— 1/2 .25 .2.U.
V2- 2 .50 INSPECTION RECORD
2— 5 1.00
5— BS 1.50
is— SO 2.50
50-200 5.00
SIGNS: NO.TRANS,
NO.LAMPS
SERVICE 0-500V 1.00
SERVICE OVER 500V 5.00
Misc.
WIRING PERMIT 1.00
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERM IT .50
TOTAL FEE s
I 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.
I 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. -7 POWER
SIGNATURE / UTILITY CO.NOTIFIED
OF PERM ITTE
FINAL, vT' '
®e A ATION ARTHUR C.VEIT,
crc mo cwsH SUPERVISING ELECTRICAL ENGINEER
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