HomeMy Public PortalAbout5820-5820 1/2TEMPLE CITY BLVD_Electrical 76AG63-CES06,k0,74 APPLICATION i8it ECTRI AL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER F'P uv �,
BUILDING AND SAFETY DIVISION
T
FOR APPLICANT TO FILL IN T,
OUTLETS N0. EACH FEE FIRM ORE�Sp �f. b
AM
RECEPT._ $ $ MAIL
LIGHT TOTAL
FIRST 20 25 ADDRESS,60-2-0eA %
CITY TEL. N0. '
SWITCH_ OVER 20 .10 PLAN CHECK
LIGHTING TOTAL
FIRST 20 .25 APPLICANT
FIXTURES
OVER 20 •10 ADDRESS
RESIDENTIAL APPLIANCES CITY �? TEL. NO.
PERMIT
RANGE DRYER_WTR. HTR. APPLICAN 6J SZ � V
STA. COOK DISP. F,A.U. ADDRESS 1 08LI Tr fZQ&As l
SPACE HTR. AIR COND. CITY F=� TEL. N0Taf4 _j0 'tfj
CLOTHES WASH. DISHWASH. LICENSE OR CLASS ]
REG. NUMBE
FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS 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 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE
I - 10 3.00 DESCR SIDENTIAI�PR PERTY. p
PERMI 6
\/1 p
10 - 50 8.00 SIGNATUR O.w,.l� CD
50 - 100 10.00 DISTRICT N PROCESSY BY W
1. a
100 - S00 18.00 �O Z
SIGN, GAS' SIGN AND ONE CIRCUIT 8.00 -0 APPROVALS DATE INSPFCTOR;0lIGNATURR
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE
SERVI CENOT OVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK
SERVI CE OVER 600 VOLTS OR 200 AMP 10.00 ROUGH CONDUIT
TEMP SERVICE,POLE,&APPURTENANCES 8.00 WIRING
TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES
POWER AUTHORIZED
UTILITY CO. NOTIFIED
FINAL -72
PERMIT FEE (SUB TOTAL) NOTES:
PLAN CHECK FEE
PERMIT ISSUING FEE 3.00
TOTAL FEE
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
77G 013 2u 12.00 ,&,6
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE