HomeMy Public PortalAbout4946TEMPLE CITY BLVD_Electrical (2) 76A666-CE806 E-06 APPLICATION FOR ELlfCTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING,/t,/( �,
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIEY COUNTY ENGINEER
10 1
COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY
NEAREST
R APPUCANT TO FILL CROSS ST 971 T
RHC6PT TOTAL No EACH
"TM, FIRST 20 6 20 6 OWNER btF
LIGHT
MAIL
SWITCH OVER 20 10 'ADDRESS
TOTAL FIRST 20 EO CITY TEL NO
LIGHTING FIXTURES _
PI XTURES ADD L 1D CONTRACTOR
OVER 20
RANGES ORYu• WTR HTIRS Too ADDRESS
OAR[ DIY RA COOK CITY TEL NO
DISHWASH AUTO WARN STATE
YAC[MIO RTA AML So LICENSE NO
Moroasl oY[R NOT OVER M P -01SkTRICJ NO 11=1 ZT/9 PRYE D BY
o — 1 3 100 D0 ;D
1 — g 1/ 16o 1so INSPECTION RECORD
a — B goo
S f6 ago
1S SO 300 d
O
SO 100 goo
iL
610N61 NO TRANS
ac
No LAMPS 0 O
SERVICE O 600V NOT OVER 200A 100
SERVICE O 600V OVER 200 A I
N
Z
SERVICE OVER 60041 S
OTHER (SE[ COMPLETE FEE SCHEDULE)
PERMIT ISSUING PEE IIOff- p
SUPPLEMENTARY PERMIT ISSUING FEE DA IM
TOTAL PEE
I HEREBY ACKNOWLEDGE THAT I HAVE READ TICATION UNDERSEAS WORK 7 ,�
AND STATE THAT THE ABOVE 1[CORRECT AND AGREECOMRY ROUGH CONDUIT
WITH ALL COUNTY 0ROINANC[R AND [TATE LALATING
ELECTRICAL WIRING WIRING
I HEREBY CERTIFY THAT I AM PROPERLY REGIAND/OR FIXTURES
LICENSED AS REQUIRED B LOS ANGELES COUNTAT[ OF
CALIfORN1A OR THAT I N[L[OAL OWMER OF [NO TO PDW�q[BIOE IN TH[ABOV q18 R[SID TI P
SIGNATURE UTILITY CO NOTIFIED
OF PERMITTEE
INAL
(DATION JOAPH C ROOXAN
Q[ MO CASH SUPERVISING ELECTRICAL ENGINEER
8635 MAY 18 2 D 6.10 - o