HomeMy Public PortalAbout4343TEMPLE CITY BLVD_Electrical I 76A653-CE806 11/]0
APPLICATION FOR ELECTRI AC L42R�MlT ,� LJ
COUNTY OF LOS ANGELES
DERARTMENT OF COUNTY ENGINEER BILDING
1
BUILDING AND SAFETY DIVISION DoaESS COLEMAN W JENKINS u r ND NT UILJAU
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
OUTLETS O EACH FE
E S OWNER - Lcd Lora/
RECEPT_ MAIL
LIGHT_ TOTAL
FIRST 20 2S ADO KESSZ L r ✓
OVER 20 CITY t. [ TEL NO r'0 6
SWITCH10 PLANCHEC
LIGHTING TOTAL FIRST 20 25 APPLICANT A2Nq -k
FIXTURES OVER 20 10 ADDRESS L" (_ (.. v 'Ip
APPLIANCES CIT :tU (Lj AIG) TEL N06 —V
RANGE_DRYER_WTR HTR_ PERMIT
APPLI CAN Imo.e4 A(2 G'.O.a. Q L
STA COOK_DISP_F A U
ADDRESS L�LbC O!t(AAa C R L. 6(SPACE HTR _AIR COND Cl l i._D�P2.iw L> TEL NO Q
CLOTHES WASH DISHWASH_ LICENSE NO 7,518 CLASS C-Zt
FAN_OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COMPLY
MOTORS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND NE�� NP KW KVA ELECTRICAL WIRING
SIZE B TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AMD/OR
0 - I 100 LIC E NS EO AS REDU IRED BY LOB ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
1 - 10 300 B RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY OL
10 - 50 ypD SIGNATURE V
OF PERMITTEE
OC
50 - 100 1000 DISTRICTNO ASS ZO f PROCE 9Ep Y O
100 - S00 mop �0 d
SIGN GAS SIGN AND ONE CIRCUIT 500 NOTES
Z
TUBE OR
MARQUEE ADDITIONAL CIRCUITS 100
SERVICE NOTOVER 600 VOLTS OR 200 AMP 300
SERVICEOVER6GO VOLTS OR200AMP 1000 APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP POWER POLE
TEMPSERVICE POLE 9 APPURTENANCES 500
UNDERSLAB WORK
TEMP LIGHT OR RECEPT SYSTEM 300
ROUGH CONDI UT
WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FEE (SUB TOTAL)
UTILITY CO NOTIFIED
PLAN CHECK FEE
FINAL
PERMIT ISSUING FEE 300 JO E C ROOHAN
TOTAL FEE ow SUPERVISING ELECTRICAL NGI VEEP
PLAN CHECK VALIDATION cK M 0 CASH PERMIT VALIDATION cK V CASH
.00SELCLo 7 3 0-1 DEC 2]_ 2 D 6.00-
SEE
E SACK OF APPLICATION FOR COMPLETE SCHEDULE