HomeMy Public PortalAbout5472TEMPLE CITY BLVD_Electrical 7BAee3-cee05 11,TD APPLICATION FO ELECTiAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER ADDREESS 5472 TBMPLB CITY BLVD.
BUILDING AND SAFETY DIVISION
COLEMAN W JENKINS, SUPIERINTENDIENT OF UI LOCALITY TEWLE CITY
NEAREST o��Syr��w.S�Ey..t��.E
FOR APPLICANT TO FILL IN CROSS ST BRvADMY
OUTLETS FE S $ mm
SSES{�AMM
RECEPT_
OWNER I
MAIL
LIGHT I TOTAL
FIRST 20 1 25 25 ADDRESS 5472 TBMPLB CITY BLVD.
CITY TBWLE CITY TEL NO 286-4011
SWITCH_ 1 OVER 20 10 PLAN CHECK
LIGHTING FIRST 20 1 25 25 APPLICANT
TOTAL
FIXTURES 1' OVER 20 10 ADDRESS
APPLIANCES CITY TEL NO
RANGE
PERIT
_DRYER_WTR HTR_ PP CANT FRIESS BLEMRIC COMPANY
STA COOK_DISP _F A U _ ADDRESS 1042 S. SAN GABRIEL BLVD.
SPACE HTR AIR COND CITY .SAN GABRIBL TEL NO 286-1155
CLOTHES WASH DISHWASH_ LICENSE NO 201026 CLASS
FAN_OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ TH13 APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND HEATERS ETC HP KW KVA ELECTRICAL WIRING °
91ZE S TYPE OVER TO
IHEREBY CERTIFY THAT I AM PROPERLY REGISTERED AMD/OR
O _ 1 100 LIC E NSEO AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CA LIEORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO Y
1 — 10 Soo REBIDE IN THE ABOVE DESCRIBED RESIDENTIAL PROPERTY O
SIGNATU10 - 50 500AN
PNA
ERMRITTEE /X.L02i o[
$O - 10O 1000TRICTNO CLASS ZO SSED BY O
100 - 500 15WE Q '�— tLLJ
0
SIGN GAS SIGN AND ONE CIRCUIT 500TESTUBE OR
MARQUEE ADDITIONAL CIRCUITS 100
SERVICENOTOVER 600 VOLTS OR 200 AMP 300
APPROVALS DATE INSPECTOR'$SIGNATURE
SERVI CEOVER 600 VOLTS OR 200 AMP 1000
MP POWER POLETEMPSERVICE POLE &APPURTENANCES 500
ERSLAB WORK
TEMP LIGHT OR RECEPT SYSTEM 300
ROUGH CONDIUT
WIRING
FIXTURES
POWER AUTHORIZED
PERMIT FEE (SUB TOTAL)
UTILITY
UTILITY CO NOTIFIED
PLAN CHECK FEE
FINAL �y
PERMIT ISSUING FEE 300 ,3 00
JOSEPH C ROOHAN
TOTAL FEE ,3.50 SUPERVISING ELECT CAL ENGINEER
PLAN CHECK VALIDATION CK M D CASH PERMIT VALIDATION DK M D CASH
11('„ 1 1 4 273'. KAY 15 2 D3 50e Q
SEE SACK OF APPLICATION FOR COMPLETE SCHEDULE