HomeMy Public PortalAbout5318TEMPLE CITY BLVD_Electrical r ,
nwflreiAG[hopH APPLICATION FOR ELECTRICAL PERMIT L.I
' COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER ��oREss
BUILDING AND SAFETY DIVISION
LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
OUTLETS FEE OWNER OR
FIRM NAME
RlCEPT S 3 IMAIL
LIGHT TOTAL FIRST 20 IIS ADDRESS
���jj OVER 20 CITY TEL NO
SWITCXJ�_ 10
LIGHTING FIRST 20 APPLICANT
TOTAL
OVER 20 ADDRESS
FIXTURES 10
RESIDENTIAL APPLIANCES CITY TEL NO
PERMIT
RANGE_DRYER_WTR HTR_ APPLICANT
STA COOK_DISP _F A U _ ADDRESS LSPACE HTR AIR OOND CITY TEL NO G
CLOTHES WASH DISHWASH _ RlOnUMBER CLASS
FAN_OTHER100 I 1191198Y ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
ANO STAT[ THAT THE ADOV[ Ip CORRECT AND AGR[[ TO COMPLY
MOTORS TRANSFORMERS RATING WITH ALL COUNTY OROINANC[S,ANO STAT[ LAWS RESU LATINO
IMO HEATERS ETC HP RW KVA 9L[CTRICAL WIRING
Ili[ I TYPE OVER TO
IN[R[pA CERTIFY THAT I AM PROPERLY R[SIIT[RED AND/OR
O - 1 100 LICE HSED AD . THAI I BY LOS ANGELES COUNTY /TAT[ 01
CALF IORNIA OR THAI AM THE LEGAL HER T ♦pOV[
1 - 10 300 DESCRISED R[ NTIAL PROPERTY • O
PERMITEE Cl
10 - SO 300 SIGNATURE O
SQ - 100 10'00 DISTRIC PROCESSED BY s
W
100 - Soo 1300 D z
SIGN OAS
TUBE, OR SIGN AND ONE CIRCUIT 300 APPROVAL$ DAT[ IKV[CTOR'I SISRATUIO[
MARQUE! ADDITIONAL CIRCUITS 1A0 TEMP POWER POLE
SERVICE NOTOVER BOO VOLTS OR 200 AMP 300 UNDERSLAB WORK _
14
SERVI CE OVER 600 VOLTS OR 200 AM P 1000 ROUGH CONDUIT hq
TEMP SERVICE,POLE,B APPURTENANCES 500 WIRING
TEMP LIGHT OR RECEPT SYSTEM 300 FIXTURES :S
POWER AUTHORIZED
UTILITY CO NOTIFIED
FINAL
PERMIT FEE (SUB TOTAL) Q NOTES
PLAN CHECK FEE
PERMIT ISSUING FEE 300 Q'r]
TOTAL FEE D
PLAN CHECK VALIDATION CK M c SH PERMIT VALIDATION EK CASH
3�MG 14 2 Q 1 19 0 w�a
S[[ SACK OF APPLICATION FOR COMPLETE SCHEDULE