HomeMy Public PortalAbout5454TEMPLE CITY BLVD_Electrical Rewees ce euw 101>, APPLICATION FOR ELECTRICAL PERMITI
COUNTY OF LOS ANGELES pp
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO PILL IN LOCALITY
New Residential Bldgs &Pools EACH, NO FEE NEAREST
182 Family Sq Ft S 025 CROSS ST
OWNER OR
Multi family Sq Ft 02 — FIRMNAME
Residential Swimming Pools 25 W ADDRESS C 4
Outlets Rec Light_Sw CITY �' Tel No 7L3 B
_ First 20 _ ___ 50 PLAN CHEC
Total No -" Additionol 30 APPLICANT - --
ADDRESS
I
Lighting Fixtures First 20 50 CITY Tel No
Additional '30 PERMIT
Total No APPLICANT Q W h 6✓
Fixed Appliances Not Over I HP ADDRESS
Range—Heater_D W _ CITY Tel No
Oven_Dryer_W M_ LICENSE OR
Top —FAU —WH — REG NUMBER Class
Hood_Fon _Other_ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AMICATION AND STATE
Dlsp _ Room Air Cond — 250 THAT THE ABOVE 15 CORRECT AND AGREE TO COMAY WITH ALL COUNTY ORION
ANCES ANDSTATE LAMS REGULATING ELECTRICAL WIRING
Power Apparatus&Large Appliances
Size&Type HP KW KVA or KVAR • 1 HEREBY CERTIFY T"T I AM PROPERLY REGISTERED AND/OR LICENSED AS
2 REWIRED BY LOS ANGELES COUNTY AND STATE OF CALIFORNIA OR THAT I AM
Up THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY O
Overr I to to 10 Incl 500 C.S
Over 10 to 50 Incl 1250 PERMITTEE
Over 50 to 100 Inc 2500 SIGNATURE
Over 100 4000 1 1 DISTRICT NO ✓ O PROCESSED BY
Services L!� ��p Z
0 200 Amp Under 600V 1250 APPROVALS DATE In
EEATOORE
201 1000 Amp Under 600 V 2500
Over 1000 Amp or Over 600V 5000 TEMP POWER POLE
UNDERSLAB WORK
Temp Power Pole 8 Appurtenor<es 1000
1000 ROUGH CONDUIT
Sign wnh One Branch Grant 2 00
Addeional Sign Branch Circuits WIRING
Misc Conduits&Conductors 1000 FIXTURES
Other(See Complete Fee Schedules POWER AUTHORIZED
UTILITY CO NOTIFIED -�
FINAL
PERMIT FEE (Sub Total) NOTES 2r9 8 k,3 A
PLAN CHECKING FEE (One Fourth Permit Feel # • • • • • 2
PERMIT ISSUING FEE $700 2
TOTAL FEE O ,'•
PLAN CHECK VALIDATION CK Mo CASH i PEgMR VALIDATION CK OM.D) _81
SEE BACK OF APPLICATION FOR COMPLETSCHEDULE 4. lJ
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