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FBA66S CEBOB_B_B, APPLICATION FOR ELECTRIC PERMITi 1
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGIOVM BUILDING
BUIEDING AND.SAFETY DMSION / ADDRESS
JOHN A.LAMBIE,COUNTY ENGINEER / All
CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY
FOR APPPL�ICAIT T TO ILL 1N CRO 5r.
FM
LIGHTS RECEPTACLES SWITCHES OWNER
A-
NUMBERI ITEM_ EACH FEE MAIL -
TOTAL OUTLETS $ 10 $ D ADDRESS
-ELEC. RANGES, WATER HEATERS, CITY , r 6 JK.0 TEL.NO. .
CLOTHES DRYERS 'SO ELECTRICIAN
ELEC.SPACE HEATERS, STAT'Y. COOK- .�-
/J�f ING UNITS GARBAGE DISPOSERS,
�'V AUTO WASHERS, DISHWASHER ,2$ -•+���qq ADDRESS
LIGHTING FIXTURES .l0 L/ CITY ''L �! EL.NO
MOTORS STATE)
LICENSE NO. ! v
HORSEPOWER D STRIC NO. GRO O READY FOR INSPECTION
H.P, OVER INC.
V,B LESS .25
2 .50 INSPECTION RECORD
s 1.00
S 15 1.501
1$ 80 2.50
50 200 5.00
MISC.
SIGNS NO.TRANS
NO.LAMPS
SERVICE O-600V 1.00
SERVICE OVER 60.0V 5.00
WIRING PERMIT 1.00 �~
FIXTURE PERMIT 1.00 r^�
SUPPLEMENTARY PERMIT .50 APPROVALS
TOTAL FEE Is/0 DATE INSPECTOR'S SIGNATURE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING �,
ELECTRICAL WIRING. WIRING i 1� �•
I HEREBY CERTIFY THAT I AN PROPERLY REGISTERED AND/OR FIXTURES � �
Ii'ENSED AS REQUIRED BY LOS ANGELES COUNTYV�DTATE OF
CALIFORNIA OR THAT/ AM THE L AL 0 E E ABOVEPOWERDESCRIBED RESIDENTI hERTYSIGNATURE• �4 UTILITY CO.NOTIFIED
OF PERNITTE '` FINAL � •r� �. ty�y -7�-G„7
FOHN A.LAMBIE. VALIDATION ARTHUR C.VEIT.
;OUNTY ENGINEER CK MO CAM SUPERVISING ELECTRICAL ENGINEER
!AEn4098D; NOV 7 2 10.1.0