HomeMy Public PortalAbout5722 A-ETEMPLE CITY BLVD_Electrical 7CA063-CEBOO 3-50 / / , e541
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APPLICATION FOR ELECTRICAL PERMIT
COUNTY dF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDREss
JOHN A LAMBIE, COUNTY ENGINEER
COLEMAN W JENKINS, SUPERINTENDENT OF BUILDING LOCALITY I ,e
FOR APPLICANT TO FILL IN NEAREST
CROSS ST M
No $
SACH FEE OWNER G t4LC "-o
RECEIPT
FIRST 20 Zp
MAIL
LIGHT_ TOTAL ADDRESS �e
SWITCH_ OVER 20 10 CITY TEL NO Zia d •GO
PLAN CHECK
LIGHTING TOTAL FIRST 20 20 APPLICANT
FIXTURES �_ OVER 20 10 ADDRESS
RANGE_DRYER_WTR HTR CITY TEL NO
STA COOK_DISP _F A U _ CONTRACTOR G
SPACE HTR _AIR CORD ADDRESS ,,,� `('p O GQ,.A W
CLOTHES WASH _DISHWASH CITY T'SV TEL NO 42, 3
FAN—OTHER 1 00 LICENSE NO O CLASS (1-10
MOTORS TRANSFORMERS RATING I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
IND HEATERS ETC HP KW XVA AND *TATE THAT THE A*DVE Ie CORRECT AND AGREE TO COMPLY
SIZE 6 TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING
0 — 1 1 00 1 HERESY CERTIFY THAT 1 AM PROPERLY REGISTERED M0/OR
JCENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATEDF `
1 — 10 3 00 CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO R!
RESIDE IN THE ABOVE DESC (OLD RESIDENTIAL PROP v O
10 - SO 5 00 V
SIGNATURE
SO - 100 10D0 OF PERMITTEE ESEQ
100 - S00 500 IN
jS6
no GROUP RD E ED Sv R�F
SIGN,GAS SIGN AND ONE CIRCUIT 3 00 A 8 -7 Ds
TUBE OR / `I Z
MARQUEE ADDITIONAL CIRCUITS 1 00 U
SERV ICE NOT OVER 600 VOLTS OR 200 AMP 2 00 (� e
SERVICE OVER 600 VOLTS OR 200 AMP 5 00
TEMP SERVICE POLE, &APPURTENANCES 300 PPROVALS DAT[ %lPECTORY *IGRA I
OWER POLE
AB WORKONDUITPERMIT FEE (SUB TOTAL) SUTHORIZEDPLAN CHECK FEE (SOi PERMIT FEE)PERMIT ISSUING FEE 2 00 CO NOTIFIED
SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL p
TOTAL FEEJOSE H C ROOHAN
SUPERVISING ELECTRI L ENGINEER
PLAN CHECK VALIDATION cK M 0 CASH PERMIT VALIDATION CK M 0 CASH
IAS- 64668 "25 2 D 2.4000
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SEE SACK OF APPLICATION FOR COMPLFTF FFF .CHFnOLF