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76A663-CE806 8-62 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 7
FOR APPLICANT TO FILL IN CROSS ST. LO LL,',rL
RECEPT.
I
TOTAL NO. EACH FEE
OUTLETS (FIRST 20 9 I$2O S OWNER EVti LO P.
LIGHT
I4
O'er MAIL
ADD'L ADDRESS
SWITCH. OVER 20 10
GHTING
LTOTAL
FIRST 20 20 CITY TEL.NO.
Il
FIXTURES I ADD'L
to ELECTRICIAN S GOOVER20
RANGES CLO.ORVERS WTR.HTRS.1.00 ADDRESS qs'sg ur
GARD.DIBP. STA.COOK -
CITY O wu A, Lo'- TEL. NO.1,
DISHWASH. AUTO.-WASH. STATE
SPACE HTRS. STA.APP.(-h H.P.MAX.) 50 LICENSENO.
F -
MOTORS: OVER NOT OVER H.P. DISTRICT NO. I GR UP ZONE PRO/CESSED BY
0 1 1.00
a
Q O oVi
1 3 1:50 INSPECTION RECORD
3 8 12.00
8 is 12.50
15 50 3.00
so too 5.00 OV
SIGNS:
NO.TRANS y'
NO.LAMP9 OH
r. SERVICE 0.60OV-NOT OVER 200A 1.001 W
SERVICE 0-60OV-OVER 200 A. 12100 N
SERVICE OVER 600V 5.00
MISC.
bte.lr' L r 0d
4
PERMIT ISSUING FEE 2.00
BUPPLEMENTABY PERMIT ISSUING FEE 1.00
TOTAL FEE s 3
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INWECTOR'SSIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
J
ELECTRICAL WIRING.WIRING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESIDENTIAL PROPERTY. POWER
SIGNATURE UTILITY CO.NOTIFIED
OF PERMITTEE
FINAL
MO CASH
VALIDATION ARTHUR C.OVEIT
SUPERVISING ELECTRICAL ENGINEER
CK
1
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