HomeMy Public PortalAbout5020TEMPLE CITY BLVD_Electrical '°"°°'a W6[11`7781APPLICA Q104;rOR�LLE-tj AL ERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN
' EACH NO -- FEE ADDREF-y-
New Residemial Bldgs S Pools A DRETSS 'I
1 &2 Family Sq Ft $ 025 - b
Multi family Sq Ft 02 - N RET
25 ST
00
Residential Swimming PoolsUWNLKUR r,,.� `l �•^
FR A IT-
Outlets Rec_Light_Sw _ _ _ _ MAIL _.._ --_- -
First 20 50 AD RESS -
-Total No Additional 30 CITY t __ __ Tel No .,rte
PLPPLAN CHECK
AICANT-
Lighting Fixtures First 20 50 ADDRESS •s
-Additional' 30
Total No CITU Tel No
Fixed Appliances Not Over 1 HP - -- 7PRWI I- — - --- - - , - -
Range—Heater—D W _
APPLICANT s 0 P��� -•!-'
O47en_Drye7_W M-- ADDRESS - - - _
Top _FAU _WH - _ CITY_ �j2�/ � I NaA
Hood_Fan _Other_ LICENSE OR
Disp —Room Au Coed 250 REG NUMBER 3 3_ .—Cl-'C-1-0-
I
_ -1-0-,
I HEREBY ACKNOWLEDGE THAT HAVE APPU(C
Power ApporatusB Large Appliances_ TION AND STATE THAT THE ABOVE IS CORRGREE TO
S¢e&Type HP KW KVA or KVAR COMPLY WITH ALL COUNTY E'LA y_ 2 50REGULATING ELECTRICAL WIRING
Up to 1 Incl . 1 HEREBY CERTIFY THAT I AM PROPERLY AND/OROver 1 to IO Incl 5 00 LICENSED AS REQUIRED BV LOS ANGELES COUSTATE OFOver 10 to 501nd - 1250 _ CALIFORNIA.OR THAT_I AM THE.LE-GAL OWE ABOVEOver 50 to 100 Inc 25 DO DESCRIBED REST TIAL PROPERTYOver 100 '" 4000 - - PERaxxry1CeSDISTRICT.Nq.^ i P
0 200 Amp Under 600V
12 50 \!�
25 00 r
201-"1000 Amp Under 600V -2500
Over 1000 Amp or Over 600 V 5000 r-L �"'�•, �� 7i J
Temp Power Poled Appurtenances "1000 - < •7
Sign with One Branch Circuit 1000 -
Additionol Sign Branch Circuits I ^ 'i{ 200
FORMATION
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Other(See Complete Fee SchedulelVu # .' 2
_ 02 • • 2 '
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PERMIT FEE _ (Sub Totall _ l _._ , �
_ 9 �2 l —80
PLAN CHECKING FEE (One Fourth Permit Feel _
PERMIT ISSUING FEE .._ y7
TOTAL FEE jJ >
INSPECTION FINALED
dine 7—/ By � ^ ®s 1
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