HomeMy Public PortalAbout4351TEMPLE CITY BLVD_Electrical (2) 70Aee3 CESOB 10 Sl APPLICATION FO It PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN SUP T OF BUILDING LOCALITY E
NEAREST
FOR APPLICANT TO cR089 8T
I r E N M Ho uol Fee
OUTLETS. (FIRST IID) •IIo 0 OWNER -
LIGIm RKCST M' MAIL
OUTLETS. (ADD L UNITS) ADDRESS
LIGHTS IRCEPT E\Y 10
LIGHTING FIXTURES. (FIRST 20) 10 CITY _ TEL Nq/."
LIGHTING FIXTURES (ADDITIONAL) 10 ELECTRICIAN (�
RANGee CLO DRYKINI WTR HT" TOO ADDRESS Q
GAM Diff QfA COOK
OIeXWA➢H AUTO WALX CITY NO
STAYE
SPACE KTRS STA APP (W H P xAE) S0 LICENSE NO lieze, 9 /Q
MOTORS OVER NOT OVaxPDISTRICT�(JO GROUP ZONE P CESSED BY
o + ! 10
O r6
NAT Bo p INSPECTION RECORD
a a L 200 Q
8 Is ago
U
K
IS SO Soo O
SO 100 S DO
d
SIGNS NO TRAxe N
NO LAMPY Z
SERVICE O BOOV NOT OVER ZOOA 100
SERVICE O BODY Ova 200 A 200
SERVICE OVER GOOV S 00
MISC
r
PERMIT ISSUING FEE 200
SUPPLEMENTARY PERMIT ISSUING FEE 100
TOTAL FEE
I HERmY ACKNOWLEDGE THAT 1 HAYe READ THIS APPLIZ7ATION PPROVALS 'DATE p
INeR R SEIGNATUR[
AND STATE THAT THE ABOVE le CORRI C AND AGREE To COMPLY CONDUIT / I
WITH AL COUNTY ORDINAHCSS AND 4TATE uwe IWGULATINO �I
ELECTRICAL WIRING WIRING 1
1 HM2Y CERTIFY THAT 1 AM PROPERLY REEIIRa GIANO/OR
uEICWImD AS WQUIR BY LOS ANGe G COUNTY AND STATE OF FIXTURES
CALIFORNM OR THAT I AM THE OWNER OF THe ABOVE
DESCRIeeo REa1DENTIAL POWER
SIGNATURE UTILITY CO NOTIFIED III
OF PERMITTE FINAL
GA IDATION A UR C`VEITV
IX MO CASH SUPERVISING ELECTRICAL ENGINEER
�tl�.a 217 5 0 ; MY 17 2 D 1 3 .0 0