HomeMy Public PortalAbout4516TEMPLE CITY BLVD_Electrical T
wRaw•ON APPLICATION FOR ELECTRIC PERMIT I
DIVISION OF WELDING AND SAFETY
. DspmmiGat If County Eaylnser
COIt� Of ]AD Angel" BUILDING
WM J FOX COUNTY NGINE[R ADDRESS
• CADDATT D GRIFFIN SUP T OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PERMIT FEES CROSS ST
NUMBER EACH FEE
LIGHT OUTLETS OWNER
RECEPTACLESMAIL
WALL EW ITCHES (/✓
TOTALOUTLETS D ! CITEL N�
ELEC RANGES ze ELECTRI AN
ELEC HEATERS 2D ADDRESS
NW RACITY T!L NI
FIXTURES D I NS N
NUMBER OF LIGHT CIRCUITS - DISTRICT NO GROUP ZONE RUDY FDR IROECTIDR
NUMBER OF RECEPTACLE CIRCUITS I j
MOTORS
NUMBERHORSEPOWEC
ER FEE IN 'ON RORD
NEW MVD HP ov¢11 ING EACH
1/2 G LEIS • 25
2 Do
2 a 100
a ID 1 DO
la DO 250
DO 200 500
MISC
NO SIGNS NO TRANS
NO SIGNS NO LAMPS
FOR EACH PERMIT
WIRING $100
FIXTURES $1 DO
SUPPLEMENTARY DO APPROVALS
TOTAL FEE S DATE INSPECTOR S SIGNATURE
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS A L1 TION CONDUIT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING
ELECTRICAL WIRING
I HEREBY CERTIFY THAT I AN ROPERLY R GISTE NO OR FIXTURED
LICENSED AS REQUIRED BY LO NGELES ATE
CALIFORNIA OR THAT AN LEG N F E AS POWER
DESCRIBED RESIDENTI
SIGNATURE UTILITYCO NOTIFIED
OF PERM ITTRE FINAL
WILLIAM J.FOX.COUNTY KN4mtfE& VALIDATION A C VEIT.CHIEF ELECT INSPECTOR
ACO7 6 7 2�, SEP 8 2 1 8 0