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BA663-CES06 5-62 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING 07
BUILDING AND SAFETYDIVISION ADDRE9s
JOHN A. LAMBIE, COUNTY ENGINEER v
WILLIAM A.JENSEN.SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
RECEPT. TOTAL NO. I EACH FEE
OUTLETS .FIRST 20 em 8 ✓
5.20 11 OWNER
LIGHTMAIL
SWITCH. l� OVER 20 .10 ADDRE98
TAL
LIGHTCITY L.
ING / / F7R5T 2O 1 .20
FIXTURES I TO[(� ADD'L .f0 ELECTRIC ANAz
OV R 2O. J
RANGES CLO.DRYERB NRR.HTRB. 1.00 ADDRESS /
24
GARB.DteP. BTA.cooK CITY TEL.NO.
DISHWASH. ` AUTO.-WASH./ STXTE
SPACE HTRS. STA.APP.(Y.X.P.MAX. .50 O LICENSE NO.
MOTORse oven NOT OVER H.P. DISTRICT NO. GROUP I ZONE PROCESSED BY
0 1 1.00 IS-000
1 s 11.50 INSPECTION RECORD
s s 2.00
8 1s 2.50 d
O
1s so 3.00 U
so 100 5.00 0
SIGNSt NO.TRANS. V
NO.LAMPS W
D_
U)
SERVICE O.600V•NoT OVER 200A 1.00 Z
SERVICE O.600V•OVER 200 A. 2.00
SERVICE OVER 600V 5.00
MISC.
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
1:17 t.
TOTAL FEE ` `
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT ) —A
WITH ALL•COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED B LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 THE 7LEGAILWNE OF ABOVE 6DESCRIBED RESIDENTIAL OP rPOWER
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITTEE FINAL
/VALIDATION ARTMIR C. VEIT
/ J MO CASH SUPERVISING ELECTRICAL ENGINEER
L-rUo o 0 7 0: JAM 2 3 2 D 17.0 0
L� oy
7GA666-CES061-67 APPLICATION FOR ELECT ICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALI.
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
RECEPT, 1 TOTAL NO. EACH FEE
LIGHT
I OUTLETS FIRST 20 ffi.20 $ MAIL
OWNER
J}
SWITCH ADD'L 10 ADDRESS
OVER 20
TOTALCITY TEL.NO. �/
LIGHTING 1 FIXTURES FIRST 20 .20
FIXTURES J( ADD'L. 1O C0NTRACTO
OVER 20 fi�tt,, T
RANGES DRYERS WTR.HTRS. 1.00 ADDRESS 40 40 ,
GARB.DISP. STA.COOK CI TEL.NO. ,;9
DISHWASH. AUTO.-WASH. STATE //
SPACE HTRS. STA. APPL. .50 LICENSE NO. ca d
MOTORSs OVER NOT OVER H.P. DISTRICT NO. GP ZO E P ED Y
o t 1.00 �` ® @�
I 8 1.50 INSPECTION RECORD
a s 2.00
B 1 s 2.50
15 50 8.00
� O
50 100 5.00
SIGNSI
NO.TRANS. OC
NO.LAMPS O
SERVICE 0-SOOV.NoT OVER 200A 1.00 i7, It116
F •.r_�Y
SERVICE 0-GOOV.OVER 200 A. 2.00 k M a Z
SERVICE OVER SOOV 5.00
�s ,r
OTHER (SEE COMPLETE FEE SCHEDULE) �F3f
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 APPROVALS DATE INSPECTOR'S SIGNATURE
TOTAL FEE i
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION UNDERSEAS WORK
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ROUGH CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT T LEGAL OWNER OF,AND INTEND TO POWER
RESIDE IN,THE E D i D SIDENTIAL PROPERTY.
SIGNATURE UTILITY CO.NOTIFIED
OF FERMI
FINAL '' '"` :°? �® •`
LIDATION J SEPH C. ROOHA
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
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