HomeMy Public PortalAbout5021AGNES AVE_Electrical (3) 76A663A C f8 4/72 APPLICATION FOR ELE R C"ERMIT '
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEERTEMPLE C DRESS 5021 NORTH AGNES �V—�
BUILDING AND SAFETY DIVISION
LOCALITY
NEAREST
FOR APPLICANT TO FILL IN CROSS ST
OUTLETS No EACH FEE OWNER FOLTZ, ARHTUR
$
$ MAIL
RECEPT ADDRESS ABOVE
LIGHT TOTAL FIRST 20
OVER 20 CITY TEMPLE CITY TEL NO 285-8573
SWITCH_ PLAN CHECK
LIGHTING TOTAL FIRST 20 APPLICANT
FIXTURES
OVER 20 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL NO
RANGE DRYER PERMIT
WTR HTR APPLICANT TRANE HCC
STA COOK DISP F A U _ X ADDRESS 2034 NO PECK RD
SPACE HTR AIR COND CITY SO EL MONTE TEL NO 579-7982
CLOTHES WASH DISHWASH LICENSE NO 265094 CLASS C-20
FAN OTHER I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
1 50 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 KA ELECTRICAL WIRING V
SIZE & TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 — 1 LICENSED AS REOU IRED BY LOS ANGELES COUNTY AND STATE OF V
CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO LLA
1 — 1O RESIDE N THE ABOVE DES RIPED RESIDE NTIA PRO ERTY N
Z
10 — 50 SIGNATURE 7 -0
OF PERM ITTE Q f- �V
50 - 100
DMIST NO CI ASS ZO PROCE ED BY
100 — 500 "o
SIGN GAS SIGN AND ONE CIRCUIT NOTES
TUBE OR
MARQUEE ADDITIONAL CIRCUITS f
SERVICENOTOVER600 VOLTS OR 200 AMP
SERVI CE OVER 600 VOLTS OR 200 AMP APPROVALS DATE INSPECTOR S SIGNATURE
TEMP POWER POLE
TEMP SERVICE POLE &APPURTENANCES
UNDERSLAB WORK
TEMP LIGHT OR RECEPT SYSTEM
ROUGH CONDIUT
WIRING _x —9 Z
r
FIXTURES
PERMIT FEE (SUB TOTAL) 1 SO POWER AUTHORIZED
UTILITY CO NOTIFIED
PLAN CHECK FEE
FINAL
PERMIT ISSUING FEE 4 50
L�
TOTAL FEE 6 00
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION �� M o CASH
662r'i--%1 Ay 3 2 0 6008-
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