HomeMy Public PortalAbout5849 TEMPLE CITY BLVD_Electrical OB S-A 4-40 10M i - APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY ��� �
COUNTY OF LOS ANGELES ' iI
WM J. FOX. CHIEF ENGINEER t�
NATURE OF INSTALLATION DISTRICT NO. G/RQUP ZONE PERMIT No..
WIRING FIXTURESSERVICE (-I
RECEIVED BY READY FOR `•,DATE ISSUED•
RANGE HEATER POWER gfOOO ! FIRST INSPECTION C
SIGNS MISCELLANEOUS J. r ' --
,! /�, APPLIC//ANT FILL IN HIPAVI Y OUTLINED PORTION ONLY
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R 4�A �e�f� f{f�'VGI.*I 69Ap t-, [���#_�I '��/�t Ff'r��.�r ADDRESS
V ADDRESS-�S pal .0 LOCALITY
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NEAREST
CR
08 ST
COUNTY d,
CERT. NO. IXPIRES NAME
—p
DESCRIPTION OF WORK :1• z- MAILej
NUMBER OF OUTLETS ON CIRCUITS 3 ADDRESS -,,+_7 .�Q
LOCATION BY ROOMS O
CITY TEL No..
LIGHT CUTLETS SW. PLUGS In= I AM THE LEGAL POSSESSOR OF THE ABOVE LOS
CIRCUIT ANGELES COUNTY CERTIFICATE OF QUALIFICATION.
f:A I B C D E F •I G- '-H-I
LIVING ROOMELECTRICIAN
1 AM T LEGAL OWNER OF THE PROPERTY DESCRIBED
DINING ROOM __ [ y ABOVE:
BRFST. RM.
i
OWNER.
BATH
CORRECTIONS
ENT. HALL r1-4
HALL Nov
FRONT PORCH
OUTSIDE
KITCHEN
—1 J
SERV. PCH.
BoRM. No. __ Z
T O
CLOSET TI O
BORM. NO. �.
CLOSET7 .
r
TOTAL
NO. OF OUTLETS $ APPROVALS
NO. OF FIXTURES $ DATE INSPECTOR'S NAME
NO. OF MOTORS / H.. P. $ J 0 CONDUIT
NO. OF SIGNS TRANS. $ ( WIRING
NO. OF RANGES OR HEATERS $ FIXTURES
MISCELLANEOUS $ POWER
PERMIT FEE $ 6 UTILITY CO.NOTIFIED
TOTAL FEE $ J'�� FINAL � �� & / ' �•