HomeMy Public PortalAbout5722 A-ETEMPLE CITY BLVD_Electrical (2) 7e•ee3-cEe06 e.6B APPLICATION FOR ELECTRICAL PERMIT "
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS 7'2 `
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS, SURRINTENDENT OP BUILDING LOCALITY
FOR APPLICANT TO PILL IN NEAREST ,
CROSS STNo
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HT_ TOTAL FIRST 20 20 ADDRESS .y+ ��'TfVV p •Tr
TCH_ OVER 20 10 ' CITY `L TEL NO Zp O a K
PLAN CHECK
HTING iTOTAL FIRST 20 20 APPLICANT
TURES /( OVER 20 10 ADDRESS
RANGE—DRYER-ZWTR HTR _ CITY TEL NO
STA COOK_DISP _F A U CONTRAC iORE
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SPACE HTR —AIR CORD _ gDDRESS k03S. A-
CLOTHES WASH LDISHWASH CITY TEL NO 2 W
FAN_OTHER At, I DD P91LICENSE NO Z 3 Q CLASS G t4
MOTORSTRANSFORMERS RATING
IND HEATERS ETC HP KW KVA 1 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE 0 TYPE OVER TO SAND STATE THAT THE ABOVE Ip CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING
0 - 1 1 00
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
11 - 10 3 00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIIORNIA OR THAT I AM THE LEGAL OWNER OF
AND INTEND TO
` 10 BO f DO RESIDE IN THE ABOVE DESCPIIEO RESIDENTIAL PROPERTY
50 - 100 10 00 SIGNATURE 1
OF PERMITTEE CD
100 - 500 15 00 =
SIGN GAS DI IC-LNG GS011P, P ESSED BY CD
TUBE OR SIGN AMO ONE CIRCUIT 300 tZ'`S5 1_� — �
W
MARQUEE ApDI TI ORAL CIgCUITB 100 NOTES N
SERVICE NOT OVER 600 VOLTS OR 200 AMP 2 00
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SOMI CE WER 600 VOLTS OR 200 AMP S 00
TEMP SERVICE POLE S:APPURTENANCES 3 00 APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP POWER POLE
UNDERSLAa WORK
ROUGH CONDUIT
WIRING A
PERMIT FEE (SUB TOTAL)
FIXTURES
PLAN CHECK FEE ISO% PERMIT FEE)
POWER AUTHORIZED
PERMIT ISSUING FEE 2 00 UTI LI TY CO NOT,FRED
SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL
TOTAL FEE (�� JOSEPH C ROOHAN
SUPERVISING ELEC CAL ENGINEER
PLAN CHECK'VALIDATION CK M 0 CASH PERMIT VALIDATION CK M 0 CASH
IG5482ie JA19 2 0 ^00^
EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE