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BA663-CE606 5-62 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY.ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A. LAMBIE, COUNTY ENGINEER _
WILLIAM A.JENSEN,SUPT OF BUILDING LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CRO�I3 ST.
RECEPT. All TOTAL NO. EACH FEE
7 OUTLET FIRST 20 20.18 6)O OWNER
LIGHT h MAIL
ADDRESS'
SWITCH. �3 OVERVER20 .10 �Uq
LIGHTING TOTAL FIRST 20 I 20 L1V CITY - TEL.NO.
FIXTURES }__Z ADo'L .10 ELECTRICIAN
OV R ZO
RANGES CLO.DRYERS WTR.HTRS. 1.00 ADDRESS
GARB..DISP. BTA.cooK CITY 6eZ
��1 CL TEL.NO.
DISHWASH. AUTO.-WASH. STATE
r
SPACE HTRS. STA.APP.('/j H.P.MAX.), .SO LICENSE NO. _
MOTORS, OVER NOT OVER H.P. '.DISTRICT NO. GROUP ZONE 17;MD BY
O " 1 1.00
3 1.50 INSPECTION RECORD
3 a 2.00
8 is 2.50 a
O
1s so 3.00 U
so too 5.00
SIGNS, NO.TRANS• Q
NO.LAMPS W
�' D.
co)
SERVICE 0.600V.NOT OVER 200A 1.00 Z Z
SERVICE O-SOOV-OVER 200 A. 2.00
SERVICE OVER 600V 0.00
MISC.
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE 3
I HEREBY ACKNOWLEDGE THAT I HAVE READ.THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY .' CONDUIT ,
WITH ALL'COUNTY ORDINANCES.AND .STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR ` �:n, `- �✓
LICENSED A8 REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES j 4,f'/1"a ! "asp.'_ 1.'••�
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE -
DESCRIBED RESIDENTIAL PROPERTY. POWER R� 2
SIGNATURE UTILITY CO.NOTIFIED b r�1 C ��i��i/��x
OF PERMITTEE FINAL ��� i�C: *:y—.5 1_11 mob✓°
ARTHUR C. VEIT'
6,LIDATION
CASH SUPERVISING ELECTRICAL ENGINEER
IU) IJ' :� 7 2 D 13.30-, w