HomeMy Public PortalAbout5334TEMPLE CITY BLVD_Electrical TBABBG-ceeoe I-ee APPLICATION FOR ELECTRICAL PERMIT cul
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING T I A
BUILDING AND SAFETY DIVISION ADDRESS
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS, SUMRINTENDIENT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
NO EA-1
R E C EPT_ $ S OWNER
MAIL
LIGHT TOTAL FIRST 20 20 ADDRESS
SWITCH_ OVER 20 10 CITY TEL NO
PLAN CHECK
LILHTING TOTAL FIRST 20 20 APPLICANT
FIXTURES OVER 20 10 ADDRESS
RANGE_DRYER_WTR HTR _ CITY TEL NO
STA COOK_DISP F A U _ COIJTRACTOR
SPACE HTR —AIR COND / Q
ADDRESS � f
CLOTHES WASH _DISHWASH CITY ! ci TIL NO
FAN_OTHER 1 00 LICENSE 140 CLASS C t�
MOTORS TRANSFORMERS RATING
IND HEATERS' ETC HP KW KVA I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE d TYPE DV ER TG AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STAT[ LA W9 REGULATING
0 00 ELECTRICAL WIRING
I
HEREBY CERTIFY THAT AM PROPERLY REGISTERED AND/OR
1 - 10 3 00ENSED AS REQUIRED BY Lf ANGELES W COUNTY AND STATE OF
IFORNIA OR THAT I AM TNS LEGAL OWNER OF AND INTEND TO
10 - SO $ 00 RESIDE IN THE ABOVE OE9�ED RE OE NTIAL PROPERTY O
ATURE V
50 - 100 1000PERMITTE too - soo Is ooTRICT NO G UP NE P ESSED BYTUBE OR SIGN AND ONE CIRCUITIGN GAS 3 00 , 0 MARQUEEA001TIONAL CIRCUITS 1 00TES Z
SERVIC NOT OVER 600 VOLTS OR 200 AAP 2 00SERVICE OVER 600 VOLTS OR 200 AMP S 00TEMP SERVICE POLE &APPURTENANCES 3 00APPROVALS DATE INSPECTOR S SIGNATURE
MP POWER POLE
DERSLAB WORK
UGH CONDUIT
PERMIT FEE (SUB TOTAL) RING
TURES
PLAN
PLAN CHECK FEE (504 PERMIT FEE)
POWER AUTHORIZED
PERMIT ISSUING FEE 2 00j4o:j-6
UTILITY CO NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE1 00 FINAL
TOTAL FEE JOSEPH C ROOHAN
SUPERVISING ELE ICAL ENGINEER
PLAN CHECK VALIDATION CK M G CASH PERMIT VALIDATION CK M Q CASH
1 21 4�8 x+26 2 D 5.00- V
(
IEE BACK OF APPLICATION FOR COMRETE ME SCHEDULE