HomeMy Public PortalAbout4510TEMPLE CITY BLVD_Electrical 76AQ,63-CESOB 11/]0 ` U
APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LAS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS
COLEMAN W JENKINS, SUPOURINTENCIVENT DIP BUILDING UG 6A Z F
NEAREST D�C tl T
FOR APPLICANT TO FILL IN CROSS ST /l FD
OUTLETS NO EACHFEE p
OWNER
RECEPT_ S S MAILJ_ ADDRESS 7a lk/AF e.
LIGHT TOTAL FIRST 20 y. �, / �
SWITCH OVER 20 f0 CITY .yZ EL NO
PLAN CHECK
LIGHTING FIRST 20 ! 21• APPLICANT
TOTAL
,OGRESS
OVER 20
FIXTURES -� ID
APPLIANCES CITY TEL NO/
RANGE_DRYER_WTR HTR_ - APPLIPER 'CANT Q/.✓SC./[LO YCGCI
STA COOK_DISP _F A U _ ADDRESS c
SPACE HTR AIR COND CITY TEL 0
CLOTHES WASH DISHWASH _ LICENSE NO '_.Z /� CLASS C
FAN_OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 19 CORRECT AND AGREE TO COMPLY
MOTORS TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND HEATERS ETC HP KW KVA ELECTRICAL WIRING
SIZE A TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
O - 1 100 LICENSED AS REOUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO
I - 10 SOO RESIDE IN THE ABOVE DESCRIBED RESIDENTIAL P RTY d
O
10 - 50 SOO ]FIXTURES
IGNATURE V
F PERM ITT
SO - 100 1000 I BTI LCT NO ASS ZONE PRO O
100 - 500 1500 �, 0
SIGN GAS SIGN AND ONE CIRCUIT 500NOTES H
TUBE OR ?
MARQUEE ADDITIONAL CIRCUITS 100
SERVI CENOTOVER 600 VOLTS OR 200 AMP 300
APPROVALS DATE INSPECTOR'S SIGNATURE
SERVICEOVER 600 VOLTS OR 200AMP 1000
EMP POWER POLE
TEMPSERVICE POLE &APPURTENANCES SOO
NOERSLAB WORK
TEMP LIGHT OR RECEPT SYSTEM 300
OUGH CONDIUT
IRING
PERMIT FEE (SUB TOTAL) OWER AUTHORIZED
TILITY CO NOTIFIED
PLAN CHECK FEEINALPERMIT ISSUING FEE 300 '
XF JOSEPH C ROOHAN
TOTAL FEE SUPERVISING ELEC L ENGINEER
PLAN CHECK VALIDATION CR M D CASH PERMIT VALIDATION CK T D CASH
1" 65554 M13 20 3E5 _
BEE BACK OF APPLICATION FOR COMPLETE SCHEDULE