HomeMy Public PortalAbout4443TEMPLE CITY BLVD_Electrical (2) al v o'4- C,'.rr s
76AO63 CE806 11_71 APPLICATION FOR ELECTRICAL PERMIT LI
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER SGILo1Nc
BUILDING AND SAFETY DIVISION ADDRESS
LOCALITYNEAREST
T GS
FOR APPLICANT TO FILL IN CROSS ST OW FiP Z S
OUTLETS "
OWNER
RECEPT� S s MAIL
LIGHT_ TOTAL FIRST 20 � ADDRESS qq
SWITCH_ OVER 20 CITU "'a7
TEL NOW-3-
SWITCH—
10 PLAN CHECK
LIGHTING FIRST 20 APPLICANT
TOTAL
OVER 20 ADDRESS
FI%TURES 10
RESIDENTIAL APPLIANCES CITY TEL NO
PERMIT
RANGE_DRYER_WTR HTR_ APPLICANT S
STA COOK_DISP F A U _ ADDRESS Q 2- O
SPACE HTR AIR COND CITY > p , CZ3fFL NO 7,7 ze
CLOTHES WASH DISHWASH _ LICENSE NO CLASS
FAN_OTHER IDG 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND !TATE THAT THE ABOVE 13 CORRECT AND AGREE TO COMPLY
MOTOR! TRANSFORMER! RATING WITH ALL COUNTY ORDINANCE! AND STAT[ LAW! REGULATING
IND HRATERS ETC HP KW RVA ELECTRICAL WIRING
DILE / TYPE OVER TO
I HEREBY
CERTIFY THAT I AMGL PROPERLY REGISTERED DED AND/OR
O - 1 100 CALIFORNIAORA/ REQUIRED /Y LOS EG ANGELES COUNTY ADD STATE OF
CESIDE OR THAT IAM THE LEIS OW ESI OF AND INTEND TO O
1 - 10 !00 RESIDE IM THE ABOVE UpICRIEIO [/IDSMTI PROPERTY V
SIGNATURE /(//]�
Did
10 – SO SOO OF PERMITTEE - O
60 – 100 1ODD G
DISTRICT NOp CLA!! 20 ED SY ILLL!
100 - E00 13 DO S. OC! ` 2
SIGN GAS SIGN AND ONE CIRCUIT 500 NOTES y00
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 100
SERVICE NOTOVER 600 VOLTS OR 200 AMP SOD
S ERVI CE OVER 600 VOLTS OR 200 AM P 1040 APPROVAL! DATE UIRECTOWS SIGNATURE
TEMP POWER POLE
TEMP SERVICE,POLE, 6APPURTENANCES OW
UNDERSLAS WORK
TEMP LIGHT OR RECEPT SYSTEM SOD
ROUGH CONDIUT
WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FEE (SUB TOTAL)
UTILITY CO NOTIFIED
PLAN CHECK FEE
FINAL
PERMIT ISSUING FEE 300 3 ��
TOTAL FEE ^.'J aS
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALI ATION c/ M O CASH
5 5,5PFB- ,Vn; 2 Ir �, 325A%
311 /ACK OF APPLICATION FOR COMPLETE SCHEDULE '