HomeMy Public PortalAbout4918TEMPLE CITY BLVD_Electrical TEMPLE CITY
70Ae63 CEBO<10 el APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS me-le Y
JOHN A LAMBIE COUNTY ENGINEER
WILLIAM A JENSEN SUP T OF Skil-DING LOCALITY " n
OR O F 1 NCRAIS TL. S 3. , l Ad
IT ¢ M No a CH FSE V
o (FAIR 20) •2O 0 OWNER C Z
um.t• �� eW MAIL
OUTLET& (ADDL UNITS) ADDRESS C
LIGHn IstQr SW 10 _ �_�
S,
LIGHTING FIXTURES (FINK 20) 20 CI a- TEL NOjff
LIGHTING FIXTUREIADDRIONAL) 10 ELECTRICIAN
HAND" CLO DRreRS NTR f1TRl 100 ADDRESS
GARB DISP WA COON CITY TEL NO
DISHWA01 AVTO WASH STATE
SPACS NTILS M RA A (V.H P MAX ) SO LICENSE N
MOTORS, over NOT OVER HP DISTRI NNO GROUP OE P SEED BY
o f 100 1
a
ISO INSPK71 N RECORD r
a a 200 2- 1.f(-- O
B
15 2501 U
V m
15 60 300 0
so — loo 500
a
SIGNS, NO TRANS h
No IwrPB ?
SERVICE O SOOV NOT oVeR 200A 100
SERVICE 0600V OveS 200 A 200
SERVICE OVER SOOV 600 B
MIBC
PERMIT ISSUING FEE 200
SUPPLEMENTARY PERMIT ISSUING FEE 100
TOTAL FEE 1* 114
I HeRE6Y ACRNOWLEOGK THAT I HAv Ru0 THIS AFPuuTION APPROVALS Mr[ INYtGTom aSIGNATUR[
AND BTAT THAT THe ASOVe IS CORRZGT AND AGRei TO COMPLY CONDUIT
WITH ALL C NTT ORVINANC" AND STATE LAWS REGULATING
SLECTRICAL WIRING WIRING a PZ
1 NO®Y [
CERTIFY THAT 1 AM PROPRLY REGIBT[Rm AND/OR
LUMNSED AS REQUIRID BY IAB ANGKL COUNTY AND STATE OF FIJCTU RES
CALIFORNIA OR THAT 1 AM INK LBGAL OWNER OF THE ABOVC
DESCRIBED N""'DWTJAL FROPe POWER �L
SIGNATURE UTILITYCO NOTIFIED
OF PERM/
FINAL
VAL ? A Hc VETT
CK No MO GS SUPERVISING ELECTRICAL ENGINEER
LACp2 8 1 ltd ALS 10 2 D 4''.60^' 9
�7U��