HomeMy Public PortalAbout4946TEMPLE CITY BLVD_Electrical DK 5A555 APPLICATION FOR ELECTRIC PERMIT Z
DIVISION OF BUILDING AND SAFETY
Departaent DI County EngISGBE BUILDING
CcFox OI LOS AD SB ADDRESS rl
WM J FOJ[ COUNTY NGINEER
CASSATT D GRIFFIN SUP T OF BUILDING If
LOCALITY L
FOR APPLICANT TO FILL IN NEAREST
PERMIT FEES CROSS ST
NUMBER EACH FEE
LIGHTOUTLETS OWNER
RECEPTACLES MAIL
ADDRESS
WALL SWITCHES- I - - - -
TOTAL OUTLETS of CITY TEL
ELEC RANGES 25 ELECTRICIAN
ELEC HEATERS 25 7- ADDRESS
KW EA CITY TEL NO
FIXTURES F 5 LCE H O
NUMBER OF LIGHT CIRCUITS DISTRIC ENO GRO P 70�IE RIASY roI INSPECT1011
NUMBER OF RECEPTACLE CIRCUITS I�f I'4
MOTORS
NUMBER HORSEPOWER FEE INSPECTION RECORD
N6W MVD HP OVKR I INC EACH
e LEES S 25 `
z 50
z 5 1 00
5 15 1 50
IS 50 250
50 200 500
MISC
NO SIGNS NO TRANS
NO SIGNS NO LAMPS
FOR EACH PERMIT
WIRING $100 O O
FIXTURES SI 00
SUPPLEMENTARY 501 1 APPROVALS
TOTAL FEE S ZS DATE INSPECTOR S SIGNATURE
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION CONDUIT
ANO STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING �O ♦�
ELECTRICAL WIRING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES OUNTY AND STATE OF
CALIFORNIA OR THAT 1 AM THE GA HER OF THE ABOVE POWER
DESCRIBED RESIDENT] ERTY
SIGNATURE UTILITYCO NOTIFIED Zb
OF PERMITTEE FINAL lA
WILLIAM J FOX. COUNTY ENOINS[R VALIDATION A C VEIT,CHIEF ELECT INSPiCTOR
AC07 1 7 o-� AUG25_ 2 1 .2 5
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