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APPLICATION FOR ELECTRIC PERMIT 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS 9333 Pentland Ave*
JOHN A LAMBIE. CouNTY ENGINEER Temple Cit
WILLIAM JENSEN Sup T of BUILDING LOCALITY J
FOR APPLICANT TO FILL IN NEAREST AlesandrO
PERMIT FEES CROSSST
ITEM NUMBER I EACH FEE OWNER Baldwin
OUTLE f f J MAIL
LIOHTB RECEIR
23•w 50 10 0 ADDRESS
LIGHTING FIXTURES 13 13 10 1• O CITY TEL NO
ELEC RANGES CLO DRYERS ELECTRICIAN COnlee & son Electrie
WATER HEATERS 50 ADORESS1030
i N, GrandviewAve*
ELEC SPACE HT" DISHWAEHE G1 Jan Va r e
CITYIS.Q• fiL NO At•
GARBAGE OISPOSERSI AUTO STATE 137567 V-10
WASHERS 1 BTA COOKING UNITS 3 25 75 LICENSE NO
MOTORS OVER INC HP DISTRICTNO 1GROUP1 ZONE 1PR=SsEDBY
2 Fan &OPAUvE 2 2a 050 ✓ �L
w— z ao INSPECTION AECORD
2— a 100
a— 1a 150
1a— ao 250
ao-200 500
SIGNS NO TRANS
NO LAMPS
SERVICE O-aOOV 1 00
SERVICE OVER SOOV 500
MISC
WIRING PERMIT 100
FIXTURE PERMIT 100
SUPPLEMENTARY PERMIT DO
TOTAL FEE f
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR SIONATURE
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 THAT 1 AM PROPERLY REGISTERED ANO/OR
LICENSED All REQUIRED BY LOS ANOBLES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT J,AN THE LZG61. OWNER OF THE ABOVE POWER
DESCRIBED RESIDENT OP
SIGNATURE UTILITYCO NOTIFIED / Ill( II VV
OF PERMITTE p 1 1 IV v R'UI.V
®r /{/NIDATION SUPERVISING ELECTRICAL ENGINEER
/MO CASH \
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