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76A663-CEBOS i-62 APPLICATION FOR ELECTRICAL PERMIT
%I COUNTY OF LOB ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRES a.
JOHN A LAMBIE COUNTY ENGINEER ,
WILLIAM A JENSEN SUP T OF SUALDINO LOCALITY eXf 0M
NEAREST
1EOR C O FILL I CROSS ST
RECEPT TOTALNo sA
OUTLET
B PIR•r 20 •20 0 OWNER
LIGHT MAIL
SWITCH .;r OVER VER2 ADD
20 10
TOTAL CITY . TEL N
LIGHTING 1 ,e P1RST 20 20
4004 .24
FIXTURES I �J ov ADD•L20 10 ELECTRICIAN
R
o • wrw HTw• 100 ADDRESS
OAA! CIV RA COOK
CITY TEL NO
DISHWASH AUTO WASH STATE
RA. ( Hr MAE 1 SO LICENSE NO
MOTORS, ovals NOTOvaw H► DIST CT GROU Z NE P ESSED
O 1 100
1 — a ISO INSPECTION RECORD
a — e 200
B 1S 250
1a. ---
50 300 a
So too 500 OV
SIGNS. NO TRANS D1
NO "MPS O
SERVIC50SOOVNOTwSR200A 100
SERVICE O 600V OVER 200 A 200 - N
SERVICE OVER eOOV 500 Z
MISC „
PERMIT ISSUING FEE 200
SUPPLEMENTARY PERMIT ISSUING FEE 100
TOTAL FEE •
I HSIIS•Y ACKNOWLSOOS THAT I HAV[ RAO THA• A nON APPROVALS [41T[ SIGNATURE
A
AMO RATA THAT THS A•OYa Il CORwECT AND AOR. TO COMPLY CONDUIT
WRH ALL COUNTY OROINANCiI AND RATS LAWS REGULATING
SLSCTIIICAL WIRING WIRING
wv-
IHKRKSY
CERTIFY THAT 1 AN PROPEwLY ROISTSI® ANDIOw
LKYN® wE RDUIRD sr LOS ANGELS• COUNTY AND STATE or PDRUREa
CALIFORNIA Ow TRAY TAM TNS LEGAL O R TH[ AS
DALIFOR o R• P POVVQR
SIGNATURE' UTILI CO NOT FI
OF PQRMI
FINAL
LI ARTHUR C VEIT
CK MOO CASH
SH SUPERVISING ELECTRICAL ENGINEER
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