HomeMy Public PortalAbout5132TEMPLE CITY BLVD_Electrical (2) n Q'I
76156"' %06(6/781 'APPLICATION' F_OR ELECTRICAL PERMIT• -
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN ,�pB
New Residential Bldgs &Pools EACH NO ,FEE ADDRESS 0
132 Family Sq Ft E 025 — S —7 LOCALITY
Multi family Sq Ft 02 — NEAREST
2500 LROSS ST
EST .$�
_Revdenhal Swimming Pools _ RR__ 25 00 _ O N - _
Outlets Rec�Light�Sw L FIRM
A
Dii
First 20 50 { 6 '� ADDRE
Total No �L Additional 30 CITY Tel No
PLANCK
APPLI NT
Lghting Fixtures First 20 50 ADDRESS
Addeionol 30 _
Total No CITY Tel No
Fixed Appliances Not Over 1 HP _ PERMIT _
Range—Hewer—D W
APPLICANT
Oven=Dryer_ W M— - -' - - - ADDRESS _
Top _FAU — WH — CITY _Tel No
Hood—Fan _Other_ LICENSE OR
Disp —Room Av Cond 2 50 _ REG NUMBER .P Class
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPCA /
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 1 Incl -I HEREBV THAT I AM PROPERLY REGISTERED AND/OR
Over 1 to 10 Incl 500 LICENSED ASR IRED OS NGEL COUNTY AND STATE OF
Over 10 to SO Incl 12 50 CALIFORNIA OR T I A T LEGAL WNER OF THE ABOVE
Over 50 to 100 Inc
25 00 DESCRIBED RESIDEN Y
Over 100 4000 T
SIGNATU
SIGNUEE RE
Services DISTRICT NO - PROCESSED BY
0 200 Amp Under 600V 12 50
201 1000 Amp Under 600 V 2500
Over 1000 Amp or Over 600 V Soo ZZ
Temp Power Pole 3 Appurtenances 1000 F
Sign with One Branch Circuitt
Additional Sign Branch Circuits 12 00 INSPECTION 8 0 9 5 4 A
0 oD INFORMATION # • • • • • 2
Mac Conduits&Conductors _ ON REVERSE
Other ISee Complete Fee Schedule)_ SIDE 5 2 2 2 5 5
11 • • • 25506
PERMIT FEE (Sub Total)
1B24-7e
PLAN CHECKING FEE (One Fourth Permit Fee) 7 p
F
PERMIT ISSUING FEE 57 00 =�
TOTAL FEE i 2-5', >
INSPECTION INALED
date � 1171 BY'Z0A'WP'- / es