HomeMy Public PortalAbout5132TEMPLE CITY BLVD_Electrical J6" 2 C e0151°"" APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN p
..EACH NO FEE, ADDRESS
2 Family
New RBldgs 8 Pools
1 8 2 Family,Sq k E 025 — E LOCALITY IF
Multi family Sg Ft 02 — NEAREST
_Residential Swimming Pools_,_ 25 00 W AZ
" _
�'j FIRM NAM 4
Outlets RecLLght25w 3 rJ MAIL
First 20 50 �Z (! ADDRESS - C,
Total No -4LL Additional 30 CITY �� T_el_No ZA�6 27f
PLAN CH K
_ APPLICANT
Lighting Fixtures First 20 50 ADDRESS
Total No Additional- 30 _
CITY Tel No
Fixed Appliances Not Over 1 HP PERMIT _
Range_Heater_D W _
APPLICANT
Oven—Dryer—W M— ^ ADDRESS
Top _FAU —WH — CITVfiN TSI No�12 ],�
Hood_Fan _Olher_ LICENSE OR
Dnp _Room AirCond 250 REG NUMBER '-R Class
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA
Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO
Size&Type HP KW KVA or KVAR - - COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS
2 50 REGULATING ELECTRICAL WIRING
Up to I Incl 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
Over) to 10 Ind 5 00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
Over 10 to 50 Incl 1250 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
Over 50 to 100 Inc 2500 DESCRIB PROPERTY
Over 100 4000 PERMITEE
SIGNATURE
Services _ DISTRICT NO PROCESSED BY
0 200 Amp Under 600 V 1250 12
201 1000 Amp Under 600 V 25 DO I�
Over 1000 Amp or Over 600 V 5000
Temp Power Pole&Appurtenances 1000 , If
Sign with One Branch Circuit 1000 306
Additionol Sign Branch Circuits 200 INSPECTION
00o INFORMATION M
Mist Conduits&Conductors bd
ON REVERSE 2 5 61 A
Other(See Complete Fee Schedulel_ SIDE
Z '# * a * * 05
2 • • 2550
PERMIT FEE (Sub Total) • • • 255024
PLAN CHECKING FEE (One Fourth Permit Feel _4 Q P.02-7 9
PERMIT ISSUING FEEE7 00 X =0
TOTAL FEE =1 >
INSPECTION FINALED
date By ms
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