HomeMy Public PortalAbout5302TEMPLE CITY BLVD_Electrical M 0•A 10.41 ASM APPLICATION FOR PERMIT
DEPARTMENT OFL05 AG AND SAM= ELECTRIC 1
COUNTY OFF LOS ANGELES
WM. J. FOX CHIEF ENGINEER
NAME DISTRICT NO. GROUP ZONE PERMIT NO.
ADDRESS U ADDRESS
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R[CUIYm BY READY FOR DATE ISSUED
Y CITY TEL.NO. ,a /C/ FIRST INSPECTION / 4 �t,
W COUNTY / ; l
CERT.NO. EXPIRES
APPLICANT FILL IN HEAVILY OUTLINED PORTION ONLY
DESCRIPTION OF WORK ADDRESS
NUMBER OF OUTLETS ON CIRCUITS LOCALITY
LOCATION BY ROOMS
NEAREST
LIGHT OUTLETS SW. PLUGS lrlXT CR098
CIRCUIT A B C I D I E F 6 H I 2 NAME /v
Z MAIL
ADDRESS
O
CITY TtD�NO..
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGULEA COUNTY CERTIFICATE OF. QUALIFICATION.:
CLECTRICIAN.
1 AM THE LEGAL OWNOt G6 7HE PROPERIX DESCRIBED
ABOVE
eR.
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Q
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TOTAL O
NO. OF OUTLETS o`I • APPROVALS
NO, OF FIXTURES • DATE INSPECTOR'S NAME
NO. OF MOTORS H.P. • CONDUIT
NO. OF SIGNS TRANS. • WIRING `/ 3
NO. OF RANGES S FIXTURES
MISCELLANEOUS I POWER
PERMIT FEE • UTILITYCO.NOTIFIED
TOTAL FEE A I