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MA6634CE806 8-62 APPLICATION FOR ELECTRI AL PERfM
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING:
BUILDING AND SAFETY DIVISION ADDRESB
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY IZ
NEAREST
FOR APPLICANT TO FILL IN CROSS ST. /y
RECEPT./ TOTAL NO. EACH FEE
OUTLETS FIRST 20' 20 S OWNER
LIGHT MAIL,
ADD'L / .10 ADDRESS
SWITCH. OVER 20 /
T
OTAL- CITY �; TEL.NO.
LIGHTING FIRST20 .20FIXTURES ADO'L •1O ELECTRICIA
OVER 20 g�
RANGES CLO.DRYERS WTR.WRS. 1.00 ADDRESS.5I,6 /
.DI STA.COOK
CITY TEL.NO
DISHWASH. AUTO.-WASH., STATE •�
SPACE HTRS. STA.APP.('A N.P.MAX.) .50 LICENSE NO:
MOTORS. OVER NOT OVER H.P. DIS ICT O. 1 G O PE CESSED BY
O 1 1.00
t s 1.50 INSPECTION RECORD 61
s 8 2.00 �� f
a 15 2.50 -
15 so 3.00
P . d
50 100 1 5.00 S ' NO
SIGNS. NO.TRANS.
NO.LAMPSIfIgIval O-..
SERVICE 0.600V.NOT OVER 200A 1.00 .� IU
SERVICE O.60OV•OvER 200 A. 2.00 i ii ,
V
SERVICE OVER 600V 5.00 ?
MISC.
i
PERMIT ISSUING FEE 2.00 �Pr",y�, ,1yt+L,L,�J� y1•.
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 a
TOTAL FEE I 8
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL•COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING +♦O-Zf'6
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
LICENSED A8 REQ ED BY LOS ANGELES COU Y AND STATE OP FIXTURES
CALIFORNIA OR H T 1 M THE LEGAL OW O THE ABOVE
DESCRIBED RE
81D IAL OPERTY. POWER
SIGNATURE UTILITY CO.NOTIFIED i g
OF PERMI . e., r
FINAL
LIDATION ARTHUR C. VEIT
CK MO CASH SUPERVISING ELECTRICAL ENGINEER
LIAUO
6 1 6 0 Clal NOV 2 42 D 13.40-