HomeMy Public PortalAbout5708TEMPLE CITY BLVD_Electrical 7SA669-CEE06 9-67 APPLICATION FOR ELECTRICAL IRERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION BUILDING
JOHN A AMBIE. COUNTY ENG
LINEER ADDRESS
COLEMAN JENKINS, SUPERINrENoeNT OR BUILDING LOCALITY
N
NEAREST
FOR APPLICANT TO FILL IN CROSS $T JCS
RECEPT _1\ S OWNER �7 �J
LIGHT— TOTAL FIRST 20 20 ADDRESS 570 E7�l�L,EC/T
I1
SWITCH_ OVER 20 10 CITY 7TEL NO
LIGHTING iTOTAL FIRST 20 20 CONTRACTOR
FIXTURES I OVER 20 10 ADDRESS L/ .0
RANGE_DRYER—WTR HTR — CITY TEL NO
STA COOK_DISP F A U _ LICENSE NO
SPACE HTR —AIR CON I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY
CLOTHES WASH _DISHWASH WITH ALL COUNTY ORDINANCES AND STATE LAWS REOULATINO
ELECTRICAL WIRING
FAN—OTHER- 1 00 I HERESY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LICENSED AS REOUIRED BY LOS ANGELES COUNTY AND STATE OF
MOTORS TRANSFORMERS RATING CALIFORNIA OR TH I.A. THE LEGAL OWNER OF AND INTEND TO
IND HEATERS ETC HP KW KVA RESIpE IN TH[ VE DESCRIBED RESIDENTIAL PROPERTY
S1ZE & TYPE OVER TO SIGNATURE }
0 - 1 1 00 D OF PERMITTE 3
1 - 10 300 DISTRICT G UP ZOP3g PR S
10 - SO 500 D O
SO - 100 10 00 NOTES
100 - SOO IS 00 6
SIGN GAS SIGN AND ONE CIRCUIT 3 00
TUBE A
MAROUEE ADDITIONAL CIRCUITS 1 00
SERVICE NOT OVER 600 VOLTS OR 200 ANP 2 00
SERVICE OVER 600 VOLTS OR 200 AMP S 00
TEMP SERVICE POLE &APPURTENANCES 3 00
APPROVALS DATE INSPECTOR S SIGNATURE
TEMP POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
WIRING
ISSUING FEE
FIXTURES
SUPPLEMENTARY ISSUING FEE POWER AUTHORIZED
PERMIT FEE UTILITY CO NOTIFIED
PLAN CHECK FEE (50% PERMIT FEE) FINAL
TOTAL FEE JOSIkPlk C ROOHAN
SUPERVISING ELE
�C7RIIL ENGINEER
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION UCK /MO CASH
t
4 a 4: w v30 2 0 4.00
EEE EA"OF APPLICATION FOR COMPLETE FEE SCHEDULE