HomeMy Public PortalAbout5729TEMPLE CITY BLVD_Electrical 76A663-0680610/74 APPLICATION ORE . CTRICA PER
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER ADDRESS 5 �pZ
BUILDING AND SAFETY DIVISION
LOCALITY
a&
NEAREST Na
FOR APPLICANT TO FILE. IN CROSS ST.
OUTLETS NO. EACH FEE OWNER OR
FIRM NAME //// .
RECEPT.� $ $ MAIL
LIGHT TOTAL FIRST 20 jLo ADDRESS
d�CITY TEL. NO-;p
SWITCH, OVER 20 .10 PLAN CHECK
LIGHTINGTOTAL FIRST 20 .25 APPLICANT
OVER 20 ADDRESS
FIXTURES .10
RESIDENTIAL APPLIANCES CITY TEL. NO.
RANGE PERMIT DRYER_WTR. HTR. APPLICANT
STA. COOK DISP. F.A.U. ADDRESS
SPACE HTR. AIR COND. CITY NO
CLOTHES WASH. DISHWASH. LICENSE OR g�
REG. NUMBER 4 V CLASS JE FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLIAND STATE THAT THE ABOVE IS CORRECT AND AGREE TO MOTORS, TRANSFORMERS RATING WITHALL COUNTY ORDINANCES AND STATE LAWS REGUIND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING.
SIZE & TYPE OVER TO
'lIHEREBY CERTIFY THAT I AM PROPERLY REGISTERED Q - 1 1 �V LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STCALIFORNIA OR THAT I AM THE LEGAL OWNER OFT 1 - 10 - 3.00DESCRIBED RES NTIAL OPERTY.1 PERMITEE QA
10 — 50 5.00 SIGNATURE C3
50 — 100 1000 -=+ DISTRICT N0.100 — 500 15.00 V!dSIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTOR'S S
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE
SERVICENOTOVER600VOLTS OR200AMP UNDERSLAB WORK �j
SERVICE OVER 600 VOLTS OR 200 AMP 10A0 ROUGH CONDUIT
TEMP SERVICE,POLE,IN APPURTENANCES 5.00 WIRING fv
TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES
POWER AUTHORIZED LO /A
UTILITY CO. NOTIFIED
FINAL
PERMIT FEE (SUBTOTAL) O NOTES: QU1J2j�%
PLAN CHECK FEE �.
PERMIT ISSUING FEE v
TOTAL FEE
11;9-
PLAN CHECK VALIDATION CK. M.D.O cA;iry PERMIT VALIDATION CK. M.0. CASH
o 1 2.1 0 A98
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE