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HomeMy Public PortalAbout5909TEMPLE CITY BLVD_Electrical (2) 76A663-CE606 3-69 APPLICATIO FOR ELECTRICAL PERMIT COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING BUILDING AND SAFETY DIVISION ADDRESS �Q JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPERINTENDENT OF BUILDING LOCALITY , NEAREST FOR APPLICANT TO FILL IN CROSS ST. _Q,n NO. EACH FEE r $ $ OWNER RECEIPT._ MAIL LIGHT TOTAL FIRST 20 ,20 ADDRESS CITY TEL.N0. SWITCH OVER 20 10 PLAN CHECK LIGHTING TOTAL FIRST 20 ,20 APPLICANT FIXTURES I-/- OVER 20 ,10 ADDRESS RANGE_DRYER_WTR. HTR. CITY VL.Ng, STA. COOK_DISP._F.A.U. CONTRACTO SPACE HTR. AIR COND. ADDRESS 3 CLOTHES WASH._DISHWASH. CITY TEL.NO. i t FAN_OTHER 1.00 LICENSE NO. CLASS. MOTORS,TRANSFORMERS RATING I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION IND. HEATERS, ETC. HP. KW. KVA. AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY SIZE @TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING // ELECTRICAL WIRING. 0 - 1 / 1'00 , 4001 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF I - 10 3.00 CALIFORNIA OR THAT 1 AM HE LEGAL OWNER OF. AND INTEND TO Off. RESIDE IN, THE ABOVE D ISE D RES EN TI OPERTY. C 10 — 50 5.00 L SIGNATURE cm 50 - 100 10A0 OF PERMITTE ' C 100 - 500 15.00 DISTRICT NO. GROUP ZONE PROCESSED BY t _ ^ e a SIGNTUElET,OR SIGN AND ONE CIRCUIT 3.00 c ® ^ Z MARQUEE ADDITIONAL CIRCUITS 1.00 NOTES: SERVICE NOT OVER 600 VOLTS OR 200 AMP 2.00 SERVICE OVER 600 VOLTS OR 200 AMP 5.00 TEMP SERVICE, POLE, &APPURTENANCES 3.00 APPROVALS DATE INSPECTOR'S SIGNATURE TEMP. POWER POLE UNDERSLAB WORK ROUGH CONDUIT WIRING PERMIT FEE (SUB TOTAL) FIXTURES POWER AUTHORIZED PLAN CHECK FEE (50% PERMIT FEE) PERMIT ISSUING FEE 2.00 2 Qb UTILITY CO.NOTIFIED SUPPLEMENTARY PERMIT ISSUING FEE 1.00 1 11/0 FINAL 6 TOTAL FEE JOSEPH C. ROOHAN SUPERVISING ELECTRICAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION (:5p M.D. 40 Ar,4 6 8 0.R Ate27 2 D 3.40 '41- SEE SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE