HomeMy Public PortalAbout5837-5839TEMPLE CITY BLVD_Electrical (2) �' A LE'' E IT
76A663 CE-806(11/7-
COON OF ANGELES BUILDING AND SAFETY,
FOR APPLICANT TO FILL IN
New Residential Bldgs: .&Pools EACH NO. PEE- ADDRESS Z 3 e ' ' �..
r 1 &2-Family,Sq:Ft. = $ :025 — $. LOCALITY
Multi-family Sq.Ft. .0.2. — NEAREST
Residenfia(Swimming Pools 25.00 .. CROSS ST.
g OWNER OR -
FIRM NAME r l r
Outlets:Reif Light _ Sw- ADDRESS 1
First 20 50
Total No. Additional .30 CITY T. _ Tel-�No,
PLAN CHECK .
a _ _APPLICANT
Lighting Fixtures First 20' •50 ADDRESS
Additional 30
Total No. ' CITY �'� el.No.
FiAed Appliances Not Over 1 HP
APPLICANT
Range._Hedter_D.W.
Q
Oven Dryer_W.M.— - ADDRESS, t-"J• C1
Top _FA ,—W.H: CITY a, Tel No., -
I
Hood_Fan _.Other. LICENSE
Disp.—Room Air Cond. 2150' REG.NUMBER �, - . ' Class..C-
I'HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA,
Power Apparatus&Large.Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE-TO
Siie&T e•HP,KW,KVA,or KVAR. COMPLY' WITH ALL-COUNTY' ORDINANCES AND SfATE'tA'WS
Yp 2.50 REGULATING ELECTRICAL WIRING.
Up to 1 Incl. t HEREBY CERTIFY THAT I AM-PROPERLY REGISTERED AND/OR (�
Over 1 to 10 Incl. 5.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
Over 10 to 50 Incl. 12.50 CALIFORNIA OR THAT I ANI THE.LEGAL„OWNER.O.F,TH(:ABOVE •_®
Over 50 to 100 Inc.
25.00 DESCRIBED RESIDENTIAL PROPERTY. b.
Over 100 40.00 PERMITEE,
SIGNATURE
Services - DISTRICT NO. - PffO ED
0.200 Amp.Under 600 V 12.50//
201-1000 Amp. Under 600 V 25.00
Over 1000 Amp.or Over 600 V 50.00 / Z
Temp.Power Pole&Appurtenances 1.0.00
Sign with One Branch Circuit 10.00 C
Additiono(Sign Branch Circuits 2•.00• Y IN >
. '
Misc.Conduits&.Conductdrs 10.00 INFORMATION u. 2967 1 AON REVERSE s
Other(See Complete Fee Schedule) u 0 0 o 0 o2
SIDE , _ yZ
12.00
. o 0'O
PERMIT FEE (Sub-Total) v
I•
PLAN CHECKING FEE (One-Fourth Permit Feel O
PERMIT ISSUING FEE $7.00 x o
TOTAL FEE >
INSPECTION FINALED. ode
' W
date: By ° ®s