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6A663-CUOS 10-62 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS ,3'9�'
JOHN A. LAMBIE, COUNTY ENGINEER
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY
NEAREST �®
FOR APPLICANT TO FILL IN CROSS ST. t
REcEPT. TOTAL NO. EACH FEE
LIGHT 25 .20 FIRST 20 �O �.20 $ OWNER
�/ MAIL
AOD'l� ADDRESS
SWITCH.�/ OVER LO .10. /Q
TOTAL CITY TEL.NO.
LIGHTING ,( QQ FIRST 20 ate .20 �'
FIXTURES OVER 20 3 .10 �0 ELECTRICIAN
RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS— O(f_-l' r
GARB.DISP. STA.COOK CITY j TEL.NO. i7./rW 7
DISHWASH. AUTO.-WASH. STATE �7
SPACE HTRS. jt &AA'PP(+h H P MAX.) .50 .4h LICENSE NO.
MOTORS: ovER NOT OVER H.P. DISTRICT NO. I GR UP I ZONE PROCESSED BY
0 1 1.00 / --
1 - 8 1.50 INSPECTION RECORD 4
8 B 2.00 ^
8 is 2.50 S8
15 50 8.00
so' 100 5.00
9L
SIGNS: No.TRANS. - f
NO.LAMPS 37
SERVICE 0.600V-Nor OVER 200A 1.00 0
SERVICE 0-SOOV-OVER 200 A. 2.00
SERVICE OVER BOOV 5.00
MISC.
PERMIT ISSUING FEE 2.00 Z da ,r
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE .26190
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION "APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY CONDUIT ,q /
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING [` _
ELECTRICAL WIRING. WIRING
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR � J
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE.ABOVE
DESCRIBED RESIDENTIAL PROPERTY.. POWER
SIGNATUREi ��, e
OR PERMITTEE UTILITY CO.NOTIFIED
FINAL
IFA
LIDATION ARTHUR C. VEIT
SUPERVISING ELECTRICAL ENGINEER
CK MO CASH
6 3 8 5.0 MAR 9 2 D 2 0.90-
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