HomeMy Public PortalAbout5827-5827 1/2-5729TEMPLE CITY BLVD_Electrical �iGweea-ceeoe to/�a ��✓x�•� � � i,,,,�i.,:�%� •
APPLICATION" FOR'-:ELE'FCTRICAL PIMMIT
COUNTY OF LOS ANGELES
DEPARTMENT.OF COUNTY ENGINEER oa ,
•; BUILDING AND SAFETY DIVISION REss
LOCALITY ` .,
\
FOR APPLICANT TO FILL IN NEARESTCROSS ST, s
•.OUTLETS o• " FEe OWNER OR
FIRM NAME
RECEPT,_ S $ MAIL
LIGHT TOTAL
FIRST 20 . .25 ADDRESS
SWITCH__ OVER 20 CITY TEL. N0.
_ 'fo PLAN.CHECK
FIRST 20 25 APPLICANT
LIGHTI.•NG- TOTAL
OVER 20 ADDRESS
FIXTURES' .10
RESIDENTIAL APPLIANCES CITY TEL. No.
PERMIT '
RANGE'. ' DRYER_WTR. HTR. APPLICANT.
STA. COOKY � DISP: F.A.U. ADDRESS-
SPACE HTR, AIR COND. ' CITY TEL•.,NO..
CLOTHES WASH. DISHWASH. L CENS ' R '
- R�G. NUMBER CLASS.-
FAN
LASS:FAN _OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT L HAVE READ THIS APPL.ICAT,IOJI:
AND: STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
MOTORS., TRANSFORMERS RATING WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULAT-146•
IND, HEATERS, ETC. - .HP. KW..KVA. ELECTRICAL WIRING..
SIZE & TYPE OVER TOy
I HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR 3
0 — 1 1.00 .� LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE-OF p
CALIFORNIA OR THAI I 'AM THE LEO AL OW ER of TELE ABOVE V
y. . go 1 — 10 9.00 DESCRIBED RESIgENTIAL PROPER f �
10 — S0 5:00 PERMITEE - 7e,:Kp„p,..+ C {.�` ;r ' u.
SIGNATURE
50 — 100 IOAO
DISTRICT N0. {RROCES.� ED BY .: �, 9
100 — Boo 15.00LLJ
c-
r .!`moi:d'S+• .. -✓
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTO SSIGNATURE
•..,,,T,U;BE, OR
MPi'RQUEE' ADDITIONAL CIRCUITS. 100 TEMP. POWER POLE
SERVICE NOT OVER 600 VOLTS OR 200 AMP 3.00 UN.DERSLAB WORK
r
SERVICEOVER SOO VOLTS OR200AMP 10.00 ROUGH CONDUIT
'TEMP SERVICE,POLE,&.APPURTENANCES 5.00 WIRING
TEMP LIGHT OR RECEPT. SYSTEM 9.00 FIXTURES
POWER AUTHORIZED
UTILITY CO. NOTIFIED
FINAL
PERMIT FEE (SUB TOTAL) NOTES:
PLAN-CHECK FEE.
PERMIT ISSUING FEE 1 3.00
TOTAL FEE
PLAN CHECK VALIDATION -CK. M.O. CASH PERMIT VALIDATION CK. f'M..o. CASH
I SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE '