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78A888-CE808 8-64 APPLICATION FOR ECTRICAL ERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER -BUILDING
BUILDING AND SAFETY DIVISION ADDRESS 7-7
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A.JENSEN,SUP-T OF BUILDING LOCALITY QST
l
FOR APPLICANT TO FILL IN CROSS SST. ®rj Zt, �S
RECEPT. TOTAL NO,
EACH FEE "
/d OUTLETS FIRST 20 R.20 18 0 MAIL d Y
too
C ADD'L ADDRESS
SWITCH. �y OVER 20 -10 aC
LIGHTING TOTAL ^ F1RBT 2O �, .20 dQ CITY rQ C- a TEL.NO..
FIXTURES } /� ADD�L .10 ELECTRICIAN �. c
OV R 20
RANGES CLO.DRYERS WTR,HTRB. 1.00 ADDRESS SO 5%Fr�
GARB.DISP. � STA.COOK L r
CITY o�]Z Y`� TEL.NO. [�
DISHWASH. AUTO.-WASH. +� STATE
SPACE HTRS. BTA.APP.(ft H.P.MA .SO LICENSE NO. (9 �✓L�
MOTORS, OVER NOT OVER a1P. DIS CT GR,r Up NE P EBBED BY
O 1 1.00
1 s 1.50 INSPECTION RECORD
a B 2.00OV
s is 2.50 m
,15 so 3.00 0
SO 100 5.00 Ud
N
SIGNS[ NO.TRANS. ,Z
NO.LAMPS
SERVICE 0.600V-NOT OVER 200A 'Z 1.00
SERVICE 0-600V-OVER 200 A. 2.00
SERVICE OVER GOOV 5.00
MISC.
PERMIT ISSUING FEE 2.00 Q
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE 6
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI TION APPROVALS DATE INSPECTOR-S SIGNATURE
AND STATE'THAT THE ABOVE'IS CORRECT AND AGREE TO COMPLY CONDUIT I .If
WITH ALL-COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING Y 'l / G
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR _
LICE BED AS REQUIRED BY LOS ANGELES COUNTY ANd STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENT -PROPS POWER y�
BIGNATURE UTILITY CO.NOTIFIED ®Q 51
OF PERMITTEE , .
FINAL Std ,w•°vim "
0LIDATION ARTHUR C- VEIT
( CK/ MO CASH SUPERVISING ELECTRICAL ENGINEER
Lr1l;o 5 2 3 8% OCT 2 6 2 d 1 6,0 0Ic