HomeMy Public PortalAbout5821TEMPLE CITY BLVD_Electrical (2) 75AS8•SS
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DBS-5'A APPLICATION FOR ELECTRIC PERMIT 1
DMSION OF BUILDING ARID SAFETY
Department of County Angeles
Engineer BUILDING SO2
Coca Of 1.08 Angeles ADDRESS
WM.J.FOX.COUNTY ENGINEER
CASSATT D.GRIFFIN.SUPT OF BUILDING +�
LOCALITY / c
rim FOR APPLICANT TO FILL IN NEAREST
PL[uo+A+ FEES . CROSS ST.
NUMBER EACH FEE
LIGHT OUTLETS .a OWNER
RECEPTACLES
MAIL
ADDRESS
WALL SWITCHES S
TOTAL OUTLETS r 5¢ S CITY z TEL.NO.
ELEC.RANGES 25 ELECTRICIAN
_ELEC.HEATERS 25 ADDRESS S
KW EA CITY TEL.NO.
FIXTURES a. 5 L ZA LICENSE NO.
NUMBER OF LIGHT CIRCUITS
DISTRICT NO, GROUPI ZONE READY FOR INSPECTION
NUMBER OF RECEPTACLE CIRCUITS
MOTORS
NUMBER HORSEPOWER FEE INSPECTION RECORD
NEW MVD. HP OVER I INC. EACH
I/2&LESS $ .25
2 .50
2 5 1.00 8(�
5 15 1.50
15 50 2.50
kI 50 1 200 5.00
i
MISC.
e NO.SIGNS NO.TRANS.
NO.SIGNS NO.LAMPS
FOR EACH PERMIT: 1.
WIRING $1.00 040
FIXTURES S1.00 0 i
SUPPLEMENTARY .50 a APPROVALS
TOTAL FEE g A s� DATE INSPECTORS SIGNATURE
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION I CONDUIT
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING C^ 'Z`:�I1 ==I• �llnso
ELECTRICAL WIRING.
1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE POWER
DESCRIBED RESIDENTIA P PERTY /1
SIGNATURE UTILITY CO.NOTIFIED1l--)11 SGw ak
OF PERMITTEE+ FINAL �� v
WILLIAM J.FOX,COUNTY ENGINEER VALIDATION A.C.VEIT.CHIEF ELECT.INSPECTOR
; - 01 3 1 3- OCT 15 2 8.3 5 '
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