HomeMy Public PortalAbout5616TEMPLE CITY BLVD_Electrical (2) 76A1863-eEe0510/7Z APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES /�
DEPARTMENT OF COUNTY ENGINEER 7NAME6j
P �C_ L
BUILDING AND SAFETY DIVISION
FOR APPLICANT TO FILL IN OUTLETS NO c" x FEe cS•s• GRECEPT
LIGHT_ TOTAL
FIRST 20 ADDRESS
CITY TEL NO
SWITCH_ OVER 20 10 I PLAN CHECK
LIGHTING TOTAL FIRST 20 2J• APPLICANT
FI% 10
OVER 20 ADDRESS
TURES
RESIDENTIAL APPLIANCES CITY TEL NO
PERMIT
RANGE_ORYER_WTR HTR_ APPLICANT r I'C—:
/ G
STA COOK_DISP _F A U _ ADDRESS t i R[ p.
SPACE HTR AIR GOND �� It/, (7O CITY TEL NO Zp
CLOTHES WASH 131SHWASH 7 LEllIOR D D CLASS �—
RG NUMBER
FAN_OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE If CORRECT AND AGREE TO COMPLY
MOTORS TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND !TATE LAWS REGULATING
IND HEATER! ETC NP KW KVA ELECTRICAL WIRING
SIZE B TYPE OVIR TO
HEREBY CERTIFY TX I AM PROPERLY REGISTERED AND/OR
O — 1 100 LICE
Nf CD A9 REBYY LOS AHOCLC9 COUNTY AND STATE OF
CALIFORNIA OR THA TMA I AM THE LEO AL OWNER OF THE ABOVE y.
1 — 10 300 PEBCRIPED RCf ID IAL PROPER , O
PERMITEE U
10 — 50 500 SIGNATURE,
F
50 - 100 1000 DISTRICT NO PROCESSED BY w
100 - 500 1500 s Q Z
SIGN GAS SIGN AND ONE CIRCUIT 500 APPROVALS DATE INSPECT01PS S1014TURC
TUBE OR
MARQUEE ADDITIONAL CIRCUITS I00 TEMP POWER POLE
SERVICE NOT OVER 600 VOLTS OR200 AMP 300 UNDERSLAB WORK
SERVICEOVER 600 VOLTS OR200AMP 1000 ROUGH CONDUIT
TEMP SERVICE POLE, &APPURTENANCES 500 WIRING
TEMP LIGHT OR RECEPT SYSTEM 300 FIXTURES
POWER AUTHORIZED
UTILITY CO NOTIFIED
FINAL
PERMIT FEE (SUB TOTAL) NOTES
PLAN CHECK FEE
PERMIT ISSUING FEE 300 QQ
TOTAL FEE 17
PLAN CHECK VALIDATION CK M D CASH PERM ALIDATION cK M 0 CASH
L Af, 2 1 7 373 JUL 12 2 D 17.0 0 e a
BEE BACK OF APPLICATION FOR COMPLETE SCHEDULE