HomeMy Public PortalAbout4902TEMPLE CITY BLVD_Electrical (2) 76A66OC' 6664 " APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES JQ BUILDING AN FETY
FOR APPLICANTTO FILL IN qDD KESS D
New Residential Bldgs &Pools EACH NO - FEE
1 &2 Family Sq Ft 5 025 — S LOCALITY
Multi family Sq Ft 02 N REST'
m 2500 _
T
Reside
ial Swimming Pools _ NLRUR
FIRM NAM
Outlets Rec_;LLight 1 5w MAIL'
Fust 20 50 7.fl2 ADDRESS'
Total No _4v.4_ Additional 30 CITY
PLAN CHECK
_ APPLICANT
Lighting Fixtures Fust 20 50 ADDRESS
Additional30
Total No _ CITY - Tel No
Fixed Apphonces Not Over 1 HP _ MI
Range_Heater_D W _ APPLICANT
Oven_Dryer_W M— - ADDRESS
Top —FAU _WH _ _ CITY _ _iel Na 4
Hood Fan _Other_ LICENSE OR '
Disp _Room Air Cond 250 _ REG NUMBER Class G-/
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA
Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO
Size&T HP KW KVA or KVAR' COMPLY WITH ALL COUNTY-ORDINANCES-AND STATE LAWS
Y� 2 50 ' REGULATING ELECTRICAL WIRING
Up to I Iricl - I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
Over 1 to 10 Incl 5 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
Over 10 to 50 Ind 7250 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
25 00 DESCRIBED RESIDENTIAL PROPERTY
Over 50 to 100 Inc PERMITEE
Over 100 4000
SIGNATURE
Services _ DISTRICT NO - — - D BY
_4pi
0 200 Amp Under 600V 12 50 U V
201 1000 Amp Under 6D0 V 2500 _
Over 1000 Amp or Over 600 V 5000 q' +�
Temp TA4V-'
Power Pole&Appurtenances 10 00 p
Sign with One Branch Circuit 1000 0
Additional Sign Branch Circuits - 200—INSPECTION 13 7 4 5 A
Mis< Conduits&Conductors 1000les
INFORMATION -� # • • • • • 2
Other(See Complete Fee Schedulel_ ON REVERSE 'j'• • 'Z g 56
SIDE Z
-� • • • 2R503
0413-79
PERMIT FEE - (Sub Total)PLAN CHECKING FEE IOne Fourth Permit Z
FeelOPERMIT ISSUING FEE S700FTOTAL FEE + >
INSPECTION FINALED
date ���dl?'J By