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SASS'�,CESOS-IO-SS APPLICATION FOR ELECTRIC PERMIT
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BUILDING AND SAFETY DIVISION
Department Of Caunty Engineer BUILDING
County Of LOS Angeles ADDRESS
JOHN A.LA BIR.COUNTY ENGINEER
CASSATT D. GRIFFIN.SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL 1N CROSS ST
PERIM FEES
OWNER
LIGHTS _ RECEPTACLES 2 .3 -WITCHES
NUMBER 1 T'E M EACH F E' MAIL.
ADDRESS.
TOTAL OUTLETS $ .10 $ O�
ELEC. RANGES, WATER HEATERS, CITY' TEL.
CLOTHES DRYERS .50
ELEC. SPACE HEATERS, STAT•Y. COOK- ELECTRICIAN
ING UNITS. GARBAGE DISPOSERS, ADDRESS.
AUTO WASHERS, DISHWASHER .25
LIGHTING FIXTURES Lo Q' CITY y TTEEI NO.
IO
MOTORS LICENJ
ATESE N0. �y
HORSEPOWERC
DISTRI O. GROUP �ONr., READY FOR INSPECTION
H.P. OVER IN(;.
+/s Sc LESS .25
14 - . 2 .50 ;��'S? INSPECTION RECORD
2 5 1..00 y�
5 15 1.50
15 50 2.50 d Gt /
50 200 5.00 lool
MISC.
SIGNSI NO.TRANS
NO.LAMPS
SERVICE O-GOOV 1.00
SERVICE OVER SOOV 5.00
WIRING PERMIT 1.00
FIXTURE PERMIT 1:.00 eel
SUPPLEMENTARY PERMIT .50 931 ' APPROVALS
TOTAL FEE 8/60-
DATE INSPECTOR'S:SIGNATURE
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND .STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT I.
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING „ !i
ELECTRICAL WIRING. WIRING :� :+• / ! !
I HEREBY CERTIFY THAT i AM PROPERLY REGISTERED AND/OR
LICENSED AS REOUIRED B GELES COUNTY AND STATE OF FIXTURES r
CALIFORNIA OR THA A 'THE GAL OWNER OF THE ABOVE POWER /
DESCRIBED RESIDEN P OPERT
SIGNATURE UTILITY CO.NOTIFIED 3 s s t d ✓y
OF PERMITTEE
FINAL i .�� •s1si�1
OH.N A. LAMBIE. N ARTHURC.VEIT.
:OUNTY ENGINEER SUPERVISING ELECTRICAL:ENGINEER
rl�MLO
SX
Ga: : as r NOV 2 6 2 1 0.6 5