HomeMy Public PortalAbout5032TEMPLE CITY BLVD_Electrical (2) '°A°V°°° °° APPLICATION FOR ELECTRI(ArL PERMIT
PCOUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADORESS D3Y Al
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS, SUPERINTENDENT OF BUILDING LOCALITY
NEAREST
FH
OR APPLICANT TO FILL IN CROSS 57
A
S OWNER
MAIL
TOTAL FIRST 20 20 ADDRESS
OVER 20 10 CIT [.� , EL NO
PLAN CHECK
G iTOTAL FIRST 20 20 APPLICANT
ES I OVER 20ORYER__WTR HTR CITY TEL NO
OK_DISP 4-F A U CONTRACr/OTR _AIR COND ADDRES OS WASH —DISHWASH — CITY A TEL N OTHER I DO r LICENSE NO CLASS L�
MOTORS TRANSFORMERS RATING
IND _HEATERS ETC HP KW KVA I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE & TYPE OVER TO AMC !TATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING
0 - 1 00
I HEREBY CERTIFY THAT AM PROPERLY REGISTERED S AN°/Of
1 - 10 3 OG
LICENSED AS REQUIRED I By
HE LEGAL
OD COUNTY AND STATE OF
IPORH IA OR THAT I AM TXf LEGAL OWNER EN AND ROPER TO a
10 - 50 6 00IDE IN THE ABOVE DIp CRIIED RESIDE NTIAL PROPERTY O
SO - 100 1000NATURE u
PERMITTEE Of
Ioo — 500 Is oo . Z NE PROCESS BY �SIGN OR SIGN AND ONE CIRCUIT 3 00 TUBE ORMAgpUEE A001TIONAL CIRCUIT$ 1 00
SERVICE NOT OVER 800 VOLTS OR 200 AMP 2 00SERVICE OVER 800 VOLTS OR 200 AMP 5 00TEMP SERVICE POLE &APPURTENANCES 3 00APPROVALS DATE INSPIECTOR%SIGNATURE
MP POWER POLE
DER$LAB WORK
UGH CONDUIT
RING
PERMIT FEE (SUB TOTAL)
FIXTURES
PLAN CHECK FEE (50% PERMIT FEE)
POWER AUTHORIZED � //
PERMIT ISSUING FEE 200 �Z UTILITY CO NOTIFIED / j/
SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL �+o
TOTAL FEE JOSEPH C ROOHAN
SUPERVISING EL AL ENGINEER
PLAN CHECK VALIDATION CK M 0 CAS PERMIT VALIDATION cK M 0 CASH
LAC, 83330 FEB 10 2 D 3.00-
'SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE