HomeMy Public PortalAbout5843 TEMPLE 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