HomeMy Public PortalAbout4303TEMPLE CITY BLVD_Electrical APPLICATION FOR ELiCTRICAL P"IT T
I 76AS83 CE806 II/TO
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS 3 e
COLEMAN IN JENKIN9SuTOf8UILClINQ LOCALITY G hl
NG REST
FOR APPLICANT TO FILL IN CROSS ST
OUTLETS NO EACH F
OWNER �
RECEPT_ 9 S MAIL
LIGHT_ TOTAL
FIRST 20 36 ADDRESS a
OVER 20 CITY TEL NO
SWITCH_ 10 pLANCHECK
TOTAL
LIGHTING FIRST 20 CS APPLICANT
FIXTURES 10 _
OVER 20 ADDRESS
APPLIANCES CITY TEL NO
PERMIT
RANGE_DRYER_WTR HTR_ APPLICANT FL ec7-pz 1
STA COOK DISP _F A U _ ADDRESS �( O�K J 7-
SPACE HTR AIR COND CITY ( = ZA_ TEL NO ^���
CLOTHES WASH DISHWASH_ LICENSE NO -Roc, "( IK -2 CLASS C-IG
FAN_OTHER 100 I HERC6Y ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND !TATE THAT THE ABOVE 1! CORRECT AND AGREE TO COMPLY
MOTOR! TRANSFORMER! RATING WITH ALL COUNTY ORDINANCES AND !TATE LAW! REOOLATINO
IND HEATERS ETC HP KW MVA ELECTRICAL WIRING
SIZE S TYPE OVER TO
HERESY CERTIFY THAT I AM PROPERLY REGISTERED AHD/OR
O - t 100 LICENSED •S RCED SY L0 ANGELES COUNTY AND !TAT[ OF
CALIFOFO RNIA OR THAT HAT I AM TXC LEGAL OWNER OF AND INTEND TO
1 - 10 300 i1Q RESIDE IN THE A60YC DCICRIp[D RESIDENTIAL PROPERTY O
J Q(� SIGNATURE V
10 - 50 S00
OF PERMITTEE
-5O - 100 1000 DIITRICTN ASS OHE P ! Y O
100 - 500 1600 T d
a
SIGN GAS SIGN AND ONE CIRCUIT S00 NOTES H
Z
TUBE OR _
MARQUEE ADDITIONAL CIRCUITS IN
SERVICENOTOVER 600 VOLTS OR 200AMP 300
SERVICEOVER 600 VOLTS OR 200AMP ' 1000 D 06 APPROVAL! DATE INSPECTOR l SIGNATURE
TEMP POWER POLE
TEMPSER VICE,POLE 9APPU RTENANCES 600 w
UNDERSLAB WORK y
TEMP LIGHT OR REC EPT SYSTEM 900
ROUGH CO N DI UT
WIRING
FIXTURES
POWER AUTHORIZED 3 Z
PERMIT FEE (SUB TOTAL)
PLAN CHECK FEE "
UTILITY CO NOTIFIED
FINAL �Q L
PERMIT ISSUING FEE 300 3rJ®
SUI RO AN
TOTAL FEE b Q O SU PE RVI EL 1 L ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALID O cK M 0 CASK
Lilo 4 8 6 z N MR 10 2 D 2 .0 0- B
SEE SACK OF APPLICATION FOR COMPLETE SCH[DULE