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iAG63-CES06 5-62 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEEG� BUILDING
BUILDING AND SAFETY DIV ISION �D ADDRESS
JOHN A. LAMBIE. COUNTY ENGINEER
�7
WILLIAM A..JENSEN,SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROS.ST.
RECEPT. TOTAL L NO. EACH FEE
OUTLETS FIRST 20 $�2O S OWNER AVO
LIGHT I'd MAIL
—T j— ADO'L ADDRESS
SWITCH.. �!e OVER 20. •10
TOTAL CITY EL.NO.
LIGHTING l
;-*I FIRST 2O f .20 .�+
FIXTURES' 1 J ADD�L ,1O ELECTRICI N
OV R 20
RANGES CLO.DRYERS WTR.HTRS. i.00 ,ADDRESS
GARB.DISP. STA.COOK % CITY
EL.NO.
DISHWASH. AUTO.-WASH. ` STATE'
SPACE HTRS._ STA.APP.(V,H.P.MAX. "d- 9 .5o LICENSE NTO.w�
MOTORS, .OVER NOT OVER H.P. DIS!"IC yV� G Z P
O 1 1.00 (�fJ
1 s 1.50 INSP CTION.,iE ORD
g . 2.00
. IS 2.50 �/ �•
a
1s so 3.00 O
U
BO 100 5.00 D:
SIGNS. NO.TRANS. O
NO.LAMPS V
W
O_
SERVICE 0.000V-NOT OVER 200A 1.00 U)
SERVICE 0.600V-OVER 200 A. 2.00 Z
SERVICE OVER SOOV 5.00
MISC.
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIo APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT ) /
WITH ALL•COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. �• �`A !
WIRING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND ATE OP FIXTURES
CALIFORNIA OR THAT AM THe LEGAL OWHE OF ABOVE -p v
DESCRIBED RESIDENTI .R RTY. ' POWER
SIGNATURE UTILITY
CO.NOTIFIEDMP-M47?Y,
SI PERMITTEE ` 001( Af
LIDATION A!#THIJR C. VEIT
OCK
MO CASH SUPERVISING ELECTRICAL ENGINEER
Vila 9 2 9 1 M JAN 9 2 D 19.20-
so i_s G ry
SA653-CES06 5-62 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER!D� FAR
BUILDING ANDSAFETY DIVISION 71
All
JOHN A. LAMBIE, COUNTY ENGINEERWILLIAM A.JENSEN,SUPT OF BUILDING FOR APPLICANT TO FILL IN RECEPT. TOTAL NO. EACH FEELtalir OUTLETS FIRST 20 ffi.2O ffi M
ADD'L t0 ADDRESS
SWITCH. OVER 20
LIGHTING
TOTAL FIRST 20 .20 CITY TEL.N
1 '
FIXTURES 1 AOD'L ,1O ELECTR IAN
OV R 20 l
RANGES CLO.DRYERS WTR.HTRS. 1..00 ADDRES
GARB.DISP. A.COOK
CITY TEL.NO.
DISHWASH. AUTO.-WASH. STATE
SPACE HTRS. STA.APP.(Va H.P.MAX.) .50 LICENSE NO.
MOTORSI OVER NOTOVER H.P. DISTRICT NO. I GROUP ZONE PROCESSED BY
o t 1.00, . 0
1 /Z—I 60LOVICO
1 3 1.50 INSPECTION RECORD
3 a 2.00 q I
a Is 12.50 , O
is so 3.00 /,�' '� ��,.,.. ;, u
so too 5.00 O
SIGNBI
NO.TRANS. ~
NO.LAMPS W
D.
N
SERVICE 0.600V-NOT OVER 200A 1.001 z
SERVICE 0.600V-OVER 200 A. 2.00
SERVICE OVER SOOV 5.00
MISC.
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE ffi
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPL CATIO APPROVALS DATE INSPECTOR'S 8 O ATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY .CONDUIT
WITH ALL'COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRE Y LOS ANGE AUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT AM THE LEG OWN R OF THE ABOVE
DESCRIBED RESIDENTI P Y. POWER
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITTEE
FINAL
LIDATION ARTHUR C. VEIT
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
.I : i
L.I:JC) 4 4 r/ •:1 t"li lt\2 5 2 D 2�0 3- ti.
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