HomeMy Public PortalAbout4841TEMPLE CITY BLVD_Electrical 76A663A-CE606A 4/72 APPLICATION FOR ELECTRICAL PERMIT I..I
♦ COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS (,y
' LOCALITY ^
NEAREST
FOR APPLICANT TO FILL IN CROSS ST j
OUTLETS NO E-01. FE
_ll S OWNER
RECEPT l MAIL
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FIRST 20 p U ADDRESS
LIGHTTOTAL
CITY 't TEL NO
SWITCH OVER 20
PLAN CHECK
LIGHTING TOTAL FIRST 20 D APPLICANT
OVER 20 ADDRESS I
FI%TURES �
RESIDENTIAL APPLIANCES CITY TEL NO
RANGE—DRYERWTR HTR_ PERMIT i
APPLICANT G {C
STA COOK_DISP_F A U _ ADDRESS
SPACE HTR AIR GOND CITY G J� TEL NO �(4�0✓-/
CLOTHES WASH OISHWASH _ LICENSE NO G yz CLASSG' / U
FAN—OTHER I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
ANOSTATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS TRANSFORMER! RATING WITH ALL COUNTY ORDINANCES AND STATE LAW! REGULATING
IND HEATERS ETC HP NW RVA ELECTRICAL WIRING
SIZE 6 TYPE OVER TO r1
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AMD/OR
0 — 1 LICENSEDAS REQUIRED BY LOB ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEG NER OF AND INTEND TO
I — 10 RESIDE IN THE AS FV E DE SC &rlrR IIDEXTI PROPERTY
S
10 — 50 SIGNATURE
OF PERMITTEE
GIST RIOT MO AD!
50 — 100
X[ OC 0 By
I 00 — 500
D /
SIGN GAS SIGN AND ONE CIRCUIT NOTES
TUBE OR
MARQUEE ADDITIONAL CIRCUITS
SERVICENOTOVER 600 VOLTS OR 200 AMP t
Y
6 ERVICEOVER 600 VOLTS OR 200 AMP APPROVALS DATE IXECTOR'n SIGNATURE
TEMP POWER POLE
TEMPSERVICE POLE h APPURTENANCES
UNDERSLAB WORK
TEMP LIGHT OR RECEPT SYSTEM
ROUGH CONDIUT
WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FEE (SUB TO TALI
UTILITY CO NOTIFIED !
PLAN CHECK FEE
FINAL —�9—
PERMIT ISSUING FEE
TOTAL FEE Y
PLAN CHECK VALIDATION cK M o cAax PERMIT VALIDATION cK M D cAnx
390 28 2 _ 3.00