HomeMy Public PortalAbout5002TEMPLE CITY BLVD_Electrical I, Ci t�
74AS43C- CaaCt! 12175 APPLICATION FOR ELECTRICAL PERMIT
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO WILL In
New Residential Bldgs &Pools
EACH NO FEE ADDRESS OOZ AO
1 &2 Finally Sq Ft $ — $ LOCALITY
Multi family Sq Ft — NEAREST
OS
Residential swimming Pools CROSSST
OWNER OR
FIRM NAME
Outlets Light,Switch&Receptacle AMAIL
DDRESS .
First 20
Additional CITY I7V e1 0
PL N ECK
Lighting Fixtures AP ANT
First 20 AD ESS
Additional
CITY Tel No
Fixed Appliances Not Over 1 HP PERMITAPPLICANT
Range— Heater_ DW _ /
Oven Dryer W M ADDRESS
Top _ FAU W H CITY Tel No >
Hood Fen LICENSE OR o�o
Dlsp A C REG NUMBER Class U
X6xaaY II a TXaT i NAYS x
o x" THIS l
Power Apparatus& Large Appliances .TATs TXArTuwn CORRKCT AND woRaa r.LCCOIINTRiOLMY
.11 co uxTYoeolxAcaS 0W
AND STAT• uaS waouLwnnD
Size&Type HP, KW KVA or KVAR ELECTRICAL WIRING aL
H
Up to 1 Incl Raer can TiRY T aaoaa.1.1 Rao ur a Rao Al Z
Over 1 to 10 Ind can San w aomRao .Yr w.wrmuas cou NTY ... TATs o
u IR ISS. SOR Txwr AN T L orn.R . . weova
Over 10 to 50 Incl CASceraao wauD..T I we.x r./✓o
Over 60 to 1 DOIncl PERMITEE
Over 100 SIGNATURE
Services DISTRICT NO PFtE ED BY
J b(/S_
0-200 Amp Under 600 V `7 • 045 w-Gi�
201 1000 Amp Under 600V APPROVALS OA EO 'S
Over 1000 Amp or Over 600 V SIGNATURE
TEMP POWER POLE
Temp Power Pole&Appurtenances UNDERSLAB WORK
Sign with One Branch Circuit ROUGH CONDUIT
Additional Sign Branch Circuits
(Other) WIRING
F
FIXTURES
POWER AVTHORIZEDD(\
PERMIT FEE (Sub Total) UTILITY CO NOTIFIED I
\ ry
PLAN CHECKING FEE (Onp Fourth Permit Fee) FINAL 2 `
PERMIT ISSUING FEE NOTES $ /U6 /1k)r8f_
TOTAL FEE d�
LAN CHECK VALIDATION CK MC, CASH PERMIT VALIDATI U9 CK MO CASH
2 9 8 nJAN 20 2 D 9•0 Q A C'