HomeMy Public PortalAbout5029TEMPLE CITY BLVD_Electrical (2) (76A663 CEBDB I°"= APPLICA ON R ELECTRICAL PERMIT
Y. COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER ADDRESS 5029 Temple City blvd.
I BUILDING AND SAFETY DIVISION
LOCALITY temple city
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
OUTLETS N EACH FEE ORM MORE Tevis lambert
RECEPT $ §
MAIL as JOD
LIGHT TOTAL FIRST 20 2S ADDRESS
OVER 20 CITY TEL NO
SWITCHL � 10 PLAN CHECK
LIGHTING FIRST 20 ' ZS APPLICANT
TOT4L
OVER 20 ADDRESS
FIXTURES 10
RESIDENTIAL APPLIANCES CITY TEL NO
RANGE_DRYER_WTR HTR_ APPMICANT cobine electric CO
STA COOK-_DISP _F A U _ ADDRESS 1607 chestnut ' st•
SPACE HTR AIR GOND CITY alhambra TEL No282-0315
CLOTHES WASH DISHWASH_• LICENSE OR229847 C�
REG NUMBED CLASS
lU
FANOTHER 100 1 HENEBN ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTOR! TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAW! REGULATING
NO HEATERS ETC XP KW EVA E LECTRICAL WIRING
SIZE 6 TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
O - 1 100 O LICENSEDA! REBY LOS ANGELES COUNTY ANO STATE OF
THAI I
CALIFGRKIA °P TMA) •M THE LEGAL OWNER OF THE ABOVE
1 - 10 300 DESCPIFED RE9IOE/MT}�/L PRO/P5/j1TYPERMI `
10 - 50 SOO SIGNATEE /{/.. d/
SIGNATURE {{{«< [ QA
G
50 - 100 1000
fAA
ICT PR SSED B W
100 - 500 1Boo �Q� ye
CCC..J//SIGN GAS SIGN AND ONE CIRCUIT SODPPROVAL! DATE r' INSPE Sml%NATIIRETUBE ORMARQUEE ADDITIONAL CIRCUITS , 100POWER POLESERVICENOTOVER 600 VOLTS OR 200AMP 300SLAB WORKSERV)CEOVER600VOLTSOR200AMP Io00 CONDUITTEMPSERVICE POLE hAPPURTENANCES SOOTEMP LIGHT OR RECEPT SYSTEM 900RES AUTHORIZEDY CO NOTIFIEDPERMIT FEE (SUB TOTAL) �PLAN CHECK FEE
PERMIT ISSUING FEE 300 �
TOTAL FEE ,
PLAN CHECK VALIDATION CK M G GASH PERMIT VALIDATION cK M 0 CASH
0 3 5.7 5 A-)a
' J
SEE BACK OF APPLI LA TION FOR COMPLETE SCHEDULE