HomeMy Public PortalAbout5466TEMPLE CITY BLVD_Electrical TEA`E�`BRGE 10/74 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES Jo g c
DEPARTMENT OF COUNTY ENGINEER ADDRESS •J aLT
BUILDING AND SAFETY DIVISION
LOCALITY p E T
FOR APPLICANT TO FILL IN CROSS9ST o
OUTLETS .0 9-1 FLL ERPI RM NAOR
ME b4f:E 061
RECEPT��- S AMAI DD
RESS �•
LIGHT TOTAL FIRST 20 I 6 O
_� OVER 20 CITY /-,>,oLc� TEL NO
SWITCH IO PLAN CHECK - - - - - -
LIGHTING TOTAL FIRST 20 ZB O() APPLICANT
FIXTU RES ID
OVER 20 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL NO
PERM IT
RANGE_DRYER_WTR HTR_ APPLICANT , !/t:t.J ELL-cti C
STA COOK_DISP_F A U _ ADDRESS L /�� 190
SPACE HTR AIR COND CI Ty jr-r;1`7/045 / TEL NO
CLOTHES WASH DISHWASH _ kjFFNSEEM CLASS L/Q
FAN OTHER 100 I MKREDY ACXHOWLEDGE YHAT CI HAV! READ THIS APPLICATION
ANO STAT[ THAT TX! ABOVE IB ORRECT AND AGREE TO COMPLY
MOTORS, TRANBFORMCRS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND NlATCAS ETC HP KW RVA ELECTRICAL WINING
SIZE B TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ANOMP
0 - I100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE Or
CALIFORNIA OR THAT I AM THE LEO AL OWNER OF THE ABOVE p�
I - 10 300 DESCRIBED RESIDENTIAL PROPERTY U
1PERMITEE C
0 - 80 B00
SIGNATURE
SO - 100 IDGO DISTRICT NOOCE ED By a
100 - 600 I500 Q Z
SIGN GAS SIGN AND ONE CIRCUIT 5 D APPROVALS DATE DIlEC SBIGHATUIIE
TUBE OR
MARQUEE A TIO L 5421PS, 100 TEMP POWER POLE
SERVICENOTOV S OV LT 0 20 A 300 UNDERSLAS WORK
SERVICEOVER 600 VOLTS OR 200AMP 1000 ROUGH CONDUIT
TEMP SERVICE,POLE,6APPURTENANCCS 0W WIRING
TEMP LIGHT OR RECEPT SYSTEM 300 FIXTURES
POWER AUTHORIZED
UTILITY CO NOTIFIED '�T w�
FINAL ^ LEi-76
PERMIT FEE (SUB TOTAL) NOTES -z
PLAN CHECK FEE
PERMIT ISSUING FEE ]DO
TOTAL FEE
PLAN CHECK VALIDATION CK M CASH PERMIT VALIDATION cK M O CASH
9 2 2 r IAM 29 2 Un� 4-.1 V a y'
SEE BACK OF APPLICATION FON COMPLETE SCHEDULE ``/p/r/ I/ `