HomeMy Public PortalAbout5611TEMPLE CITY BLVD_Electrical (2) r
Oe6 SA3 ee APPLICATION! FOR ELECTRIC PERMIT Z
DIVMON OF BUUMING AND SAFETY
Department of County Engles r
i Couaty o! Los Angeles BUILDING
WM J PDX COUNTY ENGINCER ADDRESS
\ CASSATT D GRIFFIN SUP T OF BUILDING 1
LOCALITY
FOR AMT LIFE T TO FILL IN NEAREST
17-1CROSS 6T
NUMBER EACH FEE
LIGHT OUTLETS OWNER
RECEPTACLES AJ.� MAIL
ADDRESS
WALLSW ITCHES
TOTALOUTLETS a e CITY EL N
ELEC RANGES 26 rLECTRICIAN 4M Ali
ELEC HEATERS 2a ADDRESS
NW EACITY EL NO .�
FIXTURES a ICE SE NO
NUMBER OF LIGHT CIRCUITS - DISTRI NO (GROUP Z N RuoY roR INFPRCTIoN
NUMBER OF RECEPTACLE CIRCUITS ��•
MOTORS
NUMBER HORSEPOWER FEE INSPECTION RECORD
NEN' HvO HP OV[R INC EACH
p
2a
a0
2 100
a1 aoIa 2 a0a0 a 00
MISC
NO SIGNS NO TRANS
NO SIGNS NO LAMPS
FOR EACH PERMIT
WIRING SI oo U V
FIXTURES 1 00
SUPPLEMENTARY ao APPROVALS
TOTAL FEE S DATE INSPECTOR$SIGNATURE
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION CONDUIT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING I
ELECTRICAL WIRING
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED ARD/OR FIXTURES
LICENSED AS REOUIRED SY LO 6ELE3 COUNTY AND STATE OF
CALIFORNIA OR THAT 1 A HE LEGAL OWNER OP THE ABOVE POWER
DESCRIBED RESIDE L P
SIGNATURE UTILITYCO NOTIFIED
OF PERMITT FINAL lilt
WILLIAM J FOX.COUNTY ENGINR[R ViEFATION A C VEIT CHIEF ELECT INSFBCTOR
'{C,7 s 9 1 L-n SEP 13 z 1 10 ID
m