HomeMy Public PortalAbout5324TEMPLE CITY BLVD_Electrical i
76/663(;If_ao°`11 '78) , APPLICATION FOR R ELECTR_I_CA_ L PERMIT
COUNTY OF LOS ANGELES ILDING SAFETY _
FOR APPLICANT TO FILL IN JOB
New Residential Bldgs &Pools EACH-, NO FEE ADDRE _
1 &2 Family Sq Ft $ 025 — $ LOCALITY('- , `LC' G� it_
Multi family Sq Ft 02` — NEARECROSS'ST 7
_ Residential Swimming Pools_ 2500 OWNER R— --- —
FIRM NAM
Outlets RecZLight_Sw _ _ - MAIL
50
First 20 ADDRESS e
_Total No - Additional 30 CITY _ 'T-Tel No
PLAN CHECK
APPLICANT _
Lighting Fixtures First 20 50 ADDRESS
- Additional - 30
Total No , CITY i Tel No `
Fixed App'a/ Not Over-1 HP — - PERM
APPLINT i'i _ EO +,..r,,q''c 77 'P9•+STOUf - _--
Rang D W -
Oven`—Dryer_W M— ` - - I If r ADDRESS ---
ToP .FAU _ W H "xE CITY c t '. F ,.1 Te"L�a.• r...✓•A-,--
`Fio'odlG Fan, Other_ _ LICENSE OR MrY�
Disp —Room Air Canal 2 50 LICENSE
MBE t,',. ,. , Class i. , _
i I HEREBY ACKNOWLEDGE THAT],HAVE READ THIS APPLICA
Power Appororus&Large Appliances t TION AND STATE,THAT THE ABOVE IS CORRECT,AND,AGREE TO
$¢e BType HP KW KVA or KVAR '•n COMPLY,V`'ITH ALL:COUNTY-ORDINANCES-AN1)"TATE'LAVJS1 -0
"-�
REGULATING,ELECTRICAL WIRING- al
Up to 1_Incl 2 50 - i ,�_,101,1., t .� py„ I^s
I HEREBY CE&�tTIPY THAT I AM PROPERLY WGISTERED AND/OR U
Over 1 to 10 Incl 500___ LICENSED AS REOUI RED BY LOS ANGELES COUNTV"AND SPATE OF ps
Over 10 to 50 Ind 1250 _ 11F�RN IA T TsI AM THE LEGAL.OWNER OF THE ABOVE
- _ 0-✓Istai2
Over 50 to 100 Inc 2500 DESCRIBED � sr7�
Over 100- , 4000 511E IITTEE -r _ — sllh
Services - _ __ � .
DISTRICT N + LED B
0 200 Amp Under 600V 1250 `'� o e
201 1000 Amp Under 600 V 25 00
Over 1000 Amp or Over 600 V 5000 ,Z
i C v
Temp Power Pole&Appurtenances 10 00
Sign with One Branch Circuit 1000
Additional Sign Branch Circuits L '200 _ INSPECTION _ _V „
INFORMATION
M,sc Conduits&Conductors 1000 ` - -ON RENERSE�-"' 1 6 5$t,8 A ,
Other(See Complete Fee Schedule)_
SIDE _:__�. A . . . . . 2 ,
2 • •,2S50
-- --i . .
PERMIT FEE - 13ub�TotaU . 2S50d_ _ �-
PLAN CHECKING FEE Ione Fourth Permit Feel _i } d Q 7 9
PERMIT ISSUING FEE - _ $7 00
TOTAL FEE >
INSPECTION FINALED
�- /3-79 By
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