HomeMy Public PortalAbout5329TEMPLE CITY BLVD_Electrical (2) """" ' -'°"' APPLICATION FO LECTRICAL PERMIT
COUNTY OF LOS ANGELES ��ppBB
RE59
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION AOD
LOCALITY
NEAREST
FOR APPLICANT TO PILL IN CROSS ST
OUTLETS OWNER OR
RECEPT S S FIRM NAME
MAIL17
LIGHT__ TOTAL FIRST 20 �5 ADO RESS
SWITCH OVER 20 CITY TEL NO
10 PLAN CHECK '
LIGHTING TOTAL FIRST 20 ZD APPLICANT
FI%TURES 10
OVER 20 ADDRESS
RESIDENTIAL APPLIANCES amAA241U14TINNO
"NGE_DIIY ER_WTR HTR PERMIT_ APPLICA TC �
STA COOK_DISP_F A U ADDRESS 14
SPACE HTR AIR GOND = CITY 5Z p+ `A TEL NO Z7
CLOTHES WASH DISHWAS� R9GE NUMBER Do CLASS
FAN_OTHER IDG 70W I HEREBY ACNNOWLEOGE THAT 1 HAVE READ THIS APPLICATION
AND STAT[ THAT THE ABOVE 13 CORRECT AND AOR[[ TO COMPLY
MOTORS, TRANSFORMERS "TING WITH ALL COUNTY ORDINANCE[ AND STAT[ LAW[ REGULATING
IND HEATERS, ETC HP KW KVA ELECTRICAL WIRING
l IZE S TYPE OVER TO
I HERBY CERTIFY THAT I AM PROPERLY REGISTERED AMD/OR
0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY ANOSTAT[ OF
CALIFORNIA ON THAI I AM THE LEGAL OWNER OF TN[ AGOVE
1 - 10 500 OUCRIF[0 RESIDER!=Y
PIGNATUE
DIC
10 - 60 S00 SIGNATURE
SO - 100 1000 DISTRICT NO ROCES ED BY LM
100 - 600 1500 t I =
SIGN GAS SIGN AND ONE CIRCUIT S00 APPROVALS' DATE INF[ BNNMTUR[
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 100 TEMP POWER POLE
SERVI CENOTOVER 600 VOLTS OR 200 AMP SOD UNDERSLAB WORK
SERVICEOVER600 VOLTS OR200AMP 1000 ROUGH CONDUIT
TEMP SERVICE,POLE, Q APPURTENANCES 500 WIRING
TEMP LIGHT OR RECEPT SYSTEM 500 FIXTURES
POWER AUTHORIZED
UTILITY CO NOTIFIED
FINAL
PERMIT FEE (SUB TOTAL) NOTES L(,4 .✓
PLAN CHECK FEE Q f�
PERMIT ISSUING FEE
TOTAL FEE �b
PLAN CHECK VALIDATION cK 0 CABH PERMIT VALIDATION cK M 0 CASH
(-' r, 722RID 1841 U 1350S[■ BACK OF APPLICATION FOR COMPLETE SCHEDULE