HomeMy Public PortalAbout4410TEMPLE CITY BLVD_Electrical T.A"3C- CE"'S I9,79 APPLICATION FOR ELECTRICAL PERMIT �1
BUILDING D SAFETY DIVIS 11
FOR APPLICANT TO FILL IN �� .W Lv'
New Residential Bldgs &Pools
EACH NO FEE ADDRESS• 'I�Ff O �.
1 &2 Finaily Sq Ft $ — & LOCALITY G r
Multi family Sq Ft — NEAREST
Residential SwimmingPools CROSSST
OR
FIRM NAME
Outlets Light Switch & Receptacle MAIL
ADDRESS .�40i. Nr 6 I+aD
First 20 _ ������LL
Additional CITY b®M Tel No YYd ,V79
PLAN CHECK
Lighting Fixtures APPLICANT
First 20 ADDRESS
OWNil
Additional
CITY Tel No
Fixed Appliances Not Over 1 HP PERMIT
APPLICANT
Range_ Heater_ DW ADDRESS �4}s QWh/GTA..
Oven _ Dryer W M
Top _ FAU WH CITY Tel No >
Hood _ Fan LICENSE ORe.-� 60o
Dlsp _ AC REG NUMBER .301$ 09 Class c.1
CC
N....Y ......I.DO. T OTHU wPPucwION p
o .TAT. TwwTTHU weovff is CORRECT NDwolr.. To COMPLY �
Power Apparatus& Large Appliances ALL COUNTYoaoinwac.S AND STAT. LAW. a.DULATIND W
Size&Type HP KW, KVA or KVAR .L.CT,U CAL WA114D d
N
Up to 1 Incl aoT C.P .ao P.aL .msT.R.D ANoioa =
Over 1 to 10 Incl L,C...o w a.T AN..
.L.S COUNTY AND
D .TAT. o
CAL........`O i . LIOAL OWN.. OFTN. A.OY.
Over 10 to 50 Incl D.s C.A..aIS .AL ..TY
Over 50 to 1001net PERMITEE
Over 100 SIGNATURE
MINDI TRICT NO ROCE SED BV
Servlcm �.�d fl
0 200 Amp Under 600 V
201 1000 Amp Under 600 V APPROVALS DATE ISIG TURE
Over 1000 Amp or Over 600 V `
TEMP POWER POLE
Temp Power Pole&Appurtenances UNDERSLAB WORK
Sign with One Branch Circuit
Additional Sign Branch Circuits ROUGH CONDUIT
(Other) WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FEE (Sub Total) UTILITY CO NOTIFIED
PLAN CHECKING FEE (One Fourth Permit Fee) FINAL
PERMIT ISSUING FEE
TOTALFEE NOTES
PLAN / LTJ �
CHECK VALIDATION CK M O CASH PERMIT A TIO CK M O CASH
691�—DEC 15 2 D 12.00 Atd