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7GA863 CESOE 75 APPLICATION FOR ELECTRIC PERMIT 1
BUIMING AND SAFETY DIVISION
Department of County Engineer BUILDING gFORINSPEUXON. County of Loo Angeles ADDRESS U L
JOHN A LAMBIE COUNTY ENGINRMR
CASSATT D GRIFFIN SUP T OF BUILDING LOCALITY LF-
FOR
F. l
FPORMAPPLICANT FESTO FILL IN CRORA SST R.o 'D NUMBER OWNER LIGHT OUTLETS MAILQwDDRESS O T V.�JRECEPTACLES 'WALL SWITCHES FEE CITY E lTTHLNTOTALOUTLETS ® - B[ ELECTRICIAN CELEC RANGES 2S ADDRESS 3 ELEC HEATERS 2B CITY TELNW EA STATEFIXTURES 0 LICENSE NOMOTORS DIS RICTNO GROUPZONE
NONe[R HORSEPOWER FEE I
N[W NVD HP OV[R INC [ACX }�}Q}��/�� ��/�/�pT�
It LESS S 25 INSPE=ON RECORD
2 BO
2 B 100
B IB 1 SO
IS 00 250
00 200 B 00
MISC
NO SIGNS NO TRANS _
NO SIGNS ' NO LAMPS
FOR EACH PERMIT
WIRING PERMIT $1 00
FIXTURE PERMIT $100
SUPPLEMENTARY BO APPHOVAIS
TOTAL FEE f DATE INSPECTOR S SIGNATURE
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION CONDUIT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING
ELECTRICAL WIRING FIXTURES
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR _
LICENSED AS REQUIRED BY LO ANG LES COUNTY AND STATE OF POWER
CALIFORNIA OR THAT A E A OWI/ER OF TX OVE
DESCRIBED RESIDEN P E UTILITYCO NOTIFIED
SIGNATURE
OF PERMITTEE INAL
JOHN A LAMB ARTHUR C.VETT
LINTY ENGIN DAON SUPERVIGING LFCTRICAL ENGIN[ER
M8 6 5 5-� MAY 219 2 1 .1 0
TBAaBBC[BG/ ,O/:,/ APPLICATION FOR ELECTRIC PERMIT 1
BUILDING AND SAFETYDIVISION
Depcw6Maw m County Ettgln T BUILDING
of�Ang" ADDRESS
JOHN A^LA 1E.COUNTY ENGIINUM
CASSATT D. GRIMM. BUrT OP BQILOING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS STI
PERNIIT FEESOWNER
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n MBER I T t M GCM F MAIL
ADDRESS
TOTAL OUTLETS It 10 AVELBC WSES NATEN HEATER/ ITY THL NCLOTH[/ DRIEST BO ELECTRICIAN E[LEC /PAC[ H[ATSRS STATY COO[
INS UNIT/, SARBAS[ DI/POSBR/ ADDRESSAUTO NA/HERSDISHIIA/HlR p0LIGHTING FIXTURES 10 O CTY TEL NOMOTORS 4STATELI HNS NHORSEPOWERN ovEN Inc O GR P E [READY
Y.a LESS 25
p 50 INSPECTION RECORD
p B 100
e 1B 1 Bo S� P
IB Bo 250 r
BO zoo 500 L 14 V"WA
MISC
SIGNS I HO Tune
NO LAMPS
SERVICE 0.SOOV foo Y
SERVICE OVER BOOV B 00 .110
WIRING PERMIT 1 00 ��i ��
FIXTURE PERMIT 1 Do \`
SUPPLEMENTARY PERMIT BO �V APPROVAIS
LAD
TOTAL FEE 1392 DATE INSPECTOR 9 SIGNATURE
I HEREBY ACXNOWLEDGE THAT 1 HAVE READ THIS A PL CATION
AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING , WIRING 016 tot
I HEREBY CERTIFY THAT 1 M PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED Y L ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT AY HE LEGAL 'NRR OF THE ROVE POWER
DESCRIBED RES]DENT
IA R lRTY
SIGNATURE UTILITY CO NOTIFIED
OF PERMITTEE FINAL
JOHN A CAMBER VALIDATION ARTHUR C VETT,
COUNTY ENGINEER ` ARTHUR
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