HomeMy Public PortalAbout5910 TEMPLE CITY BLVD_Electrical 76A663-CE806 10. 2
APPLICATION FO ELECTR Ca PERMIT
r. COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER JOB
BUILDING AND SAFETY DIVISION ADDRESS l IT
LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
OUTLETS N0. EACH. FEE OWNER OR
FIRM.NAME
RECEPT.�JJ���/ S $ MAIL
OQ
LIGHT TOTAL FIRST 20 25 ADDRESS -
OVER 20 CITY &f,711 TEL.'NO.
SWITCH .10 PLAN CHECK'
LIGHTING TOTAL FIRST 20 25 APPLICANT
OVER 20ADDRESS rp Q'�
FIXTURES 10
RESIDENTIAL APPLIANCES CITY Lr)oLi !�!�` TEL. NO3,
PERMIT
RANGE,_,DRYER_WTR. HTR. APPL'ICAN.T c �/
STA. COOK DISP_/_F.A.U. ADDRESS
SPACE HTR. AIR COND. ` CITY EL.. NO
CLOTHES WASH. DISHWASH.L LICENSE
GEE OZENUMBER CLASS
FAN. OTHER 1.00 �'� 1 HEREBY-ACKNOWLEDGE THAT I HAVE READ THIS APPLIC'A'TION
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 AT 1 AM PROPERLY' REGISTERED AND/OR
0 - 1 100 LICENSED AS REQUI Dqf ANGELES 'COUNTYAND STATE OF
CALIFORNIA OR T 1 A E LEGAL OWNER OF THE ABOVE
1 — 10 3.00 DESCRIBED RE N L P T
O
Ci
10 - 50 5.00 PERMITESIGNATU
O
50 - 100 10.00 DISTRI,CT'NO.
OCE SED BY
W
100 - 500 15.00 D
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTOR' IGNATURE
TUBE, OR
MARQUEE .ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE
SERVICENOTOVER 600'VOLTS OR200AMP 3.00 UNDERSLAB WORK.
SERVICEOVER600VOLTSOR200AMP 10.00 ROUGH CONDUIT r
TE.MPSERVICE,POLE,&AP.PURTENANCES 5.00 WIRING
TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES ',. --7.s_. � r ,
POWER AUTHORIZED = ,
UTILITY CO. NOTIFIED
FINAL /',/I-:u J,X b/� _
`PERMIT FEE (SUB TOTAL) /V QQ NOTES:
PLAN CHECK FEE
PERMIT ISSUING FEE 3.00 5p 00
TOTAL FEE
PLAN CHECK VALIDATION CK. M.0.. CASH PERMIT VALIDATION CK. M.O. CASH.
9 6 3ru-IfEB 26 2
1 3.0 0S6
. .
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE /iP/�L,