HomeMy Public PortalAbout5759TEMPLE CITY BLVD_Electrical (2) 768663-CEBa6 10•72 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER ADDRESS �7 /�
BUILDING AND SAFETY DIVISION l S &_ C in
LOCALITY cli f>/-c C f'r
NEAREST
FOR APPLICANT TO FLLL IN CROSS ST. L(J c�n2Qy�J
OUTLETS NO. EACH FEE OWNER OR
FIRM NAME
RECEPT. S $ AMAIL
DDRESS S
LIGHT-1- TOTAL FIRST 20 .tf(/ ygp�
_ CITY it r TEL. No. 87-0-3-76
OVER 20
SWITCH 3 �S PLAN CHECK
LIGHTING 1TOTAL,
FIRST 20 25 APPLICANT
FIXTURES 10
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OVER 20 � ADDRESS
RESIDENTIAL APPLIANCES CITY TEL. NO.
L)
' ,,J
RANGE PERMIT
DRYER_WTR. HTR._ APPLICANT J h V RA COS'
1
pO
STA. COOK DISP. F.A.U. ADDRESS 1 N 1114 N 1- 1t,*
SPACE HTR. AIR COND. CITY N� ��E TEL. NO.9 f
CLOTHES WASH. DISHWASH. REG NNUM9ER 2,S ?j CLASS. P
FAN OTHER 100 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
MOTORS. TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
IND. HEATERS, ETC. HP. KW. KVA. ELECTRICAL WIRING.
SIZE & TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 — 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAI AM THE LEGAL OWNER OF THE ABOVE y.
1 — 1O 300 DESCRIFED RESIDEN .AL PROPERTY 3
10 - 50 5.00 PERMITEE
V
SIGNATU ` I=
O
50 - 100 IOAO v
DISTRICT NO OCE�ED BY y�
100 - 500 1500 _Q
SIGN. GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTOR'S SIGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE
SERVICE NOTOVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK
SERVICE OVER 600 VOLTSOR200AMP 10.00 ROUGH CONDUIT
TEMP SERVICE,POLE, IN APPURTENANCES 5.00 WIRING ✓ �� �f`1 s r-
TEMP LIGHT OR RECEPT. SYSTEM 300 FIXTURES
POWER AUTHORIZED
UTILITY CO. NOTIFIED
wo
FINAL - � •�
PERMIT FEE (SUB TOTAL) NOTES:
PLAN CHECK FEE may,
PERMIT ISSUING FEE 3.00 Al
TOTAL FEE 616
PLAN CHECK VALIDATION CK. M.O. CASH P/01MIT VALIDATION CK. M.0. CASH
4 g 6iG11,
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE