HomeMy Public PortalAbout4855TEMPLE CITY BLVD_Electrical (2) TeAee9-Cee Oe I2ee APPLICATION FOR ELECTRICAL PERMIT Lull—IIII
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS /v
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS, $UPSRINTENDENT OP BUILDING LOCALITY
NEAREST
FOR APPUCANT TO FILL IN I CROSS ST
RECEPT ii 11 TOTAL No ucN P[6
- J Vera Flaer zo R 20 S OWNER A014 004
L16HT !/ MAIL 1W
SWITCH ADD L 10 ADDRESS
OVER 2
TOTALFIRST 20I 20 CITY TEL NO
LIGHTING FIXTU E
FIXTURES ADD L OVER 201 10 CONTRACTOR
RANGES MYER• R IRM 100 ADDRESS
GARS DIV SMA COOK
CITY TEL NO
DISHWAER AUTO WARN STATE
RFAC[N STA APPL So L
LICENSE NO
MOTORS OVER NOTOVER HF DISTRICT IJOi GRO P Z014E PROCESSED BY
0 1 100
1 — S ISO INSPECTION RECORD O
a — a 200 44 i U
a — 15 250 I 0
IS a0 300
so 100 S DO a
H
Z
SIGNaI No TRANS
NO LAMPS
SERVICED SOOV NOT OVER 200A 100
SERVICE O SOOV OVER 200 A 200
SERVICE OVER Soot/ S DO
OTHER IR[[ COMPLETE F[[SCHEDULE)
PERMIT ISSUING FES 200
SUPPLEMENTARY PERMIT ISSUING FEE 100 APPROVALS DATE INSPECTOR
TOTAL FEE 7 Ar
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION UNDERSLAB WORN
ANO STAT[THAT THE ABOVE If CORRECT AND AGREE TO COMPLY ROUGH CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING WIRING Z�Z
1 HER[CT CERTIFY THAT 1 AN PROPERLY REGISTERED AND/OR FIXTURE'S
LICKNR[O AB R[OUIR[D BY L NGELER COUNTY AND STATE OF
CALIFORNIA OR THAT I M LC AL O ER OF AND INTEND TO POWER
RESIO[IN THE ABOV BED TIAL PROPERTY
SIGNATOR[ �P
OF PERM UTILITYCO NOTIFIED
ITilH
FINAL
VALIDAT J ASEPPERHC RobHAN
CK ID CASH UIBING ELECTRICAL ENGINR[R
LAGO6 5 2lZ8 DEC28 2 D 7.50- 7