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7"883{[e0a 12-aa APPLICATION FOR ELECTRI L PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER DUIIDING
BUILDING AND SAFETY DIVISION ADDREf/ 0 0
JOHN A. LAMBIE. CouNTY ENGINEER
COLEMAN W. JEtNKINS, $UKRINT=ND<NT Of BUILDING LOCALITY
N 2A RI;1T
APMCANT To FILL IN C
REC[FT. 1 OUTL6T6 No. $ A< OWNE
L,a,.R Jlr FIRE'S YO .f.0
MAIL
SWITCH ADD'L 10 ADD
OVCR Y
LIGHTING 1 FTOTAL
IXTURtg FI-RBT YO .10 PIZ rTd N
FIXTURE/ J( ADD'L
OVER YO 10 CONTRACTOR
RAN sxs DRYnes wm HrRs. 1.OQ ADDRESS
GM9 DISP. STA.COOK
cn'Y Ta No.
DIIIHWAAM. AUTO.-WASH. /TATK
QAC[HTFW ETA. APDL. .50 LICZNSK NO.
MOTORS. ovR NOT OVER H.P. DIBTRICTr. GROUPZ P
O 1 1.00
1 a 1.50 INSPECnON R CORD o
a e Y.00 2 O
DI:
e its 2.50 O
15 ISO 9.00 `
t d
5o 100 5.00 v�
NO.T7tANS-
■16N/i
NOI.Amps
/[.RVIC[0•e0OV-NOT ovot 100A 1.00
SEWICE O-EOOV-Ovnt 100 A. &QO
SZRVICi OVKR 600V 5.00
OTHER (SEE COMPL[T[F[[*CH[DUL[)
PERMIT ISSUING FQ 1.00
/UPPL MKNTA.RY FXRMIT ISSUFNG F X 1.00 AL9 DATE &nmL
TOTAL FEE
1 HK)sSY ACKNOWL[Dai THAT 1 HAV[R][AD THIS APPLI TION
UNDER/LA5 WORK
AND[TAT[THAT TRI ASOV[IS CORAICT AND.AGREE TO COMPLY ROUGH CONDUIT
WITH ALL COUNTY ORDINANCES AND STAT[ LAWS PM ULATING
ELECTRICAL WIRING. WRING t�
I HRnY CIRTI FY THA AM PROPERLY RIGIWTLRtD �OR FIXTURE/ .�
LICENSED AS RIQUIR[ Y LOS AN O[L[S COUNTY AN T[OF
CALIFORNIA OR AT M TH[L[OA.L OWNR OF. 1 D TO POWQ
R[[ID[IN,TH D[SCRIE[D NTI L
SIGNATUR UTI CON FI
OF
FINAL
VALIDATIpN---,, JOSEPH G ROOHAN
CK YO / - ] 8UFilIVI1ING OiCTRICAL bIGIN[pl
LAC03 8 8 3,1 NOV17 2 D 4.0 0,-' V
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76A663 DBS 5A 11-50 APPLICATION FOR PERMIT
DEPARTMENT OF BUILDING AND SAFETY ELECTRIC
���'
COUNTY OF LOS ANGELES
WILLIAM J. FOX, CHIEF ENGINEER
FOR APPLICANT TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO.
ELECTRICIAN i
RECEIVED BY READY FOR DATE ISSUED
ADDRESS FIRST INSPECTION —
CITYTEL. NO.
'a4E 11
COUNTY LICENSE O. EXPIRES &3d 2-- BUILDING `
PERMIt FE S ADDRESS o600
FEE
NUMBER EACH _LOCALITY
LIGHT OUTLETS NEAREST
ROSS ST.
C
RECEPTACLES Z -�
WALL SWITCHES i OWNER
TOTAL OUTLETS llt 5C (i5 MAIL
ELEC. RANGES �—_�— 25 ADDRESS
ELEC. HEATERS 25 _ CIT" TEL. NO.
FIXTURES 5 .— 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
MISC. APPLICATION AND STATE THAT THE ABOVE IS CORRECT
NUMBER OF LIGHT CIRCUITS AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
NUMBER OF RECEPTACLE CIRCUITS AND STATE LAWS REGULATING ELECTRICAL WIRING.
MOTORS �, I CERTIFY THAT I POSSESS THE ABOVE VALID LOS
NUMBER HORSEPOWER FEE ANGELES COUNTY LICENSE, OR 1 AM THE LEGAL OWNER
NEW MVD. HP OXER INC. EACH OF THE RESIDENTIAL PROPERTY DESCRIBED ABOVE.
G
I/2 6 LESS $ .25. SIGNATURE OF
PERMITTEE.—
2 s 1.00 INSPECTION RECORD
5 is 1.50
15 50 2.50 ._.
_ 50200 5.00
200 500 10.00
r
500 1000 15.00
Z
OVER 1000 20.00 -- i
M.G. SET/FREQ. CHANGER-HP r
WELDERS:AC-KVA O
GENERATORS - KW
TRANSFORMERS - KVA
TEMP. MOTORS (75% OF ORIG.)
MOVED MOTORS (75% OF ORIG.)
MISC.
SIGNS
NO. NO.TRANS.
APPROVALS
NO. NO. LAMPS
FOR EACH PERMIT: DATE INSPECTOR'S NAME
WIRING $1.00 CONDUIT _
FIXTURES $1.00 Q WIRING
SUPPLEMENTARY .50 FIXTURES
POWER _
TOTAL FEE $ UTILITY CO.NOTIFIED r
FINAL
--
COUNTY OF LOS ANGELES TEMPLE CITY 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAE TUNAS EL 0508 0305250019
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
LEGAL ID: FEES PAID ERJILDING ADDRESS-
TR: 6561 LT: 8 BL: .001 UN: .003 6008 CAMELLIA AV ;
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEMP CA 917802007
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: WOODRUFF
5385-018-016 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY
F1 12DV 15/20A BR CKTS 3.00 BR 51.75
TENANT: G2 LIGHfINO FIXTURES 5.00 LGT 9.75 ISSM ON: PROCESSED BY: PLAN BY: IRES ON:
H5 REE WASH MACH LT 3HP 1.00 WAS 10.95 06/05/03 JK 12/02/03
LA 100 AMA PANELS, MCC 1.00 PAN 38.85
TOTAL FEES 139.05 FI NAL DATE FINAL BY:
6008 CAMELLIA AV (626) 309-9968- DL-1/9- ,( l CODE:
TEMP 917602007 OF WORK
ELECTRICAL FOR ADDITION
HERRICK Y:AU (626) 319-2021-
145 ORANGE STREET SPECIAL CONDITIONS:
SAN GABR I EL 91776
CONTRACTW.-- --TEE-. W: APPROVALS DATE INSRCTOR SIGNATURE
0 FELIX CONSTRUCTION (626) 401-1391-
4924 M HALIFAX RD LIC. NO
TEMPLE CITY CA 91750 449477 B
UNDERGROUND CONDUIT
ARCHITECT OR BIGINEER: TEL. W: UFER GROUND
AU HERRICK Y. (626) 576-2704-
14� ORANGE ST. LIC. NO:
SAN GABRIEL, CA 91776 NONE
ROUGH WIRING
PLASTIC Y/M METAL Y/N
UTILITY COMPANY NOTIFIED
REPORT ID: DPR265 ROUTE TO: RSD508
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