HomeMy Public PortalAbout4836TEMPLE CITY BLVD_Electrical Tew..ac:ee:.e.e 12,7. APPLICATION FOR ELECTRICAL PERMIT
BUILDING Y DIVISION
POn AI'LICwNT TO PILL IN JOB
EACH NO FEE
ADD C4
7"Jpalde 8E (310
New Residential Bldgs & Pools �q
1 &2 Finaily Sq Ft $ — $ LOCALITY'
Multi family Sq Ft — NEAREST
Residential Swimming P0016 CROSS STOWNER OR 61 ^�
FIRM NAME 9Z2—
Outlets Light Switch&Receptacle MAIL
First 20 ADDRESS
Additional CITU Tel No
PLAN CHECK
Lighting Fixtures APPLICANT
Fiat 20 ADDRESS
Additional
CITU Tel No
1
Fixed AppliancePERMIT s Not Over 1 HP APPLICANT
Range— Heater_ DW O
Oven Dryer W M ADDRESS 2,V tW j2
Top _ FAU WH CITY
L Tel No
Hood Fan LICENSE OR �j
Disp AC REG NUMBERL ) CI.0(2—(46 U
I HERESY ACRNORL..Is T Av.N rRuunoN p
THAT TX .Ov. i. c XO . TO C..ILT U
Power Apparatus& Large Appliances CC NTY ORDINANCES.ND STATE LA..REO.L.T1.O i=I
Size&Type HP KW,KVA or KVAR L.CTR LCAL wi.ie. d
N
Up to 1 Incl =
NISNEIIIIAS C.RTII I T 1 S A ..TI A. 60 ANO/OR
Over 1 t0101nc1 A. R.THAT I TN
TLO. w rtAT. OA
CALIFORNIA OR TXAT i AM TN. L •ONNER YOAHTN.
Over 10 to 50 Incl ..<fl,.ED R.aD.NriA
Over 50 to 100 Incl PERMITEE
Over 100 SIGNATURE
Services DISTRICT NO, Q OCE ED BV
0 200 Amp Under BOO V � - 0 U t
201 1000 Amp Under 600 V APPROVALS DATE I R
Over 1000 Amp or Over 600 V SIG ATURE
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 p�
PLAN CHECKING FEE (One Fourth Permit Fee) FINAL �� O
PERMIT ISSUING FEE
TOTAL FEE NOTES
PLAN CHECK VALIDATION CK MID CASH ERMiT VA CK M O CASH
"KIFES COMPENSATION
9 s 7-SEP 22 2 e 1 3.5 0 •,�
POLICY HOLDER. S-S_ 277- V 5FO-