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HomeMy Public PortalAbout5843TEMPLE CITY BLVD_Electrical (2) I 76A563-CE60611-71 APPLICATION FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER ADDRESS �� \ BUILDING AND SAFETY DIVISION LOCA LI TY NEAREST ) FOR APPLICANT TO FILL IN CROSS ST !{/1,a,�.L� ,, J� OUTLETS NO. EACH FEE _ r �/ `f4 {J OWNER 'hVl RECEPT._ $ $ MAIL �� j,� ]�, LIGHT TOTAL FIRST 20 25 ADDRES LL��'"//�v�� b9 OVER 20 CITY � TEL. NO. SWITCH .10, PLAN CHEC If LIGHTING TOTALI FIRST 20 .Zg APPLICANT FIXTURES OVER 20 .10 ADDRESS .RESIDENTIAL APPLIANCES CITY TEL. N0. RANGE DRYER_WTR. HTR. PERMIT /� /► /�J� APPLICANT �V VG�V STA. COOK DISP. F.A.U. ADDRESS, !E5 SPACE HTR. AIR COND. CITY' r/fM TEL. NO-0`19'76 7 7 CLOTHES WASH. DISHWASH. LICENSE N0. A CLASS. �� 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 a CALIFORNIA OR THAT I AM THE LEGAL OWNER OF, AND INTEND TO 1 - 10 3.00 RESIDE IN, THE ABOV RIBED RESIDENTIAL PROPERTY. SIGNATURE 10 - 50 5.00 OF PERMITTEE O 50•- 100 10.00 DISTRICTNO. CLZONE PROCESSED BY ICI � �+/ 100 - 500 15.00 n J •tld� N SIGN, GAS SIGN AND ONE CIRCUIT I 5.00 NOTES: ? TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 SERVICENOTOVER 600 VOLTS OR 200 AMP 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE SERVI CE OVER 600 VOLTS OR 200 AMP 10.00 TEMP.POWER POLE TEMP SERVICE,POLE,INAPPURTENANCES 5:00 UNDERSLAB WORK TEMP LIGHT OR RECEPT. SYSTEM 3.00 ROUGH CONDIUT WIRING FIXTURES PERMIT-FEE (SUB TOTAL) POWER AUTHORIZED UTILITY CO. NOTIFIED �` r► PLAN CHECK FEE" �--. PERMIT ISSUING FEE 3.00 d FINAL TOTAL FEE do PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION �CKM.O. CASH ( Ar, 1 8 3 973 JUN22 2 D 8.00Ncu SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE