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APPLICATION[ FOR ELECTRIC PERMIT,
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISIONADDRESS
JOHN A.LAMBIE,COUNTY ENGINEER
CASSATT D.GRILOCALITY
FFIN,SUP T OF BUILDING
NEAREST
FOR APPLICANT TO FILL IN CROS go s
PERMIT OWNER
LIGHTS RECEPTACLES SWITCHES MAIL
NUMBER 1 TaER
EACH FE ADDRESS
TOTAL OUTLETS .10 $
ELEC. RARGES, WS. .50 CITY 0•
cLOTRES DRYERS ELECTRICIAN
/ ELEC.SPAC ��► t
ING UNITS. GARBS, ADDRESS e
AUTO WASH •25'LIGHTING FIXT !0 CITY
r- STATE
MOTORS LICENSE NO. !
HORSEPOWERQ..! O (J' O READY FOR INSPECTION
rt
'H.Po OVER INC.
e LESS .25 1 LLI I ;r/
2 2 •50 INSPECTION RECORD
2 S 1.00
5 15 1.5tY
15 50 2.50
SO 200 5.00
Mlsm
SIGNS N0.TRANH
NO.LAMPS
SERVICE O-GOON 5.00 pV
SERVICE OVER BOON 5.00
WIRING PERMIT 1.00
FIXTURE PERMIT 1.00
SUPPLEMENTARY PERMIT •50 APPROVALS
TOTAL FEE DATE INSPECTOR'S SIGNATURE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPIUCATION
AND STATE THAT THE AS 15 CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORD CES AND STATE LAWS REGULATING WIRING 'YP
ELECTRICAL WIRING.
I HEREBY CERTI T AT I PROPERLY REGI RED AND/OR FIXTURES
LICENSED AS REOUI L GELES COUNTY NO
STA -
CALIFORNIA OR THA AM E G OWNE F HE OYE POWER
DESCRIBED RESIDER PRO
SIGNATURE UTILITY CO.NOTIFIED
OF PERM" FINAL JI♦9A ..o
IOHN A LAmalle YA=ATION ARTHUR/C. IT.
-OUNTY',NGINEER SUPERVISING ELECTRICAL ENGINEER
CIC No CASH
'�:3 S
-Co V 3 1 7 6D OCT 10 2 �