The URL can be used to link to this page

Home My Public Portal About5426 CLOVERLY AVE_Electrical__ �76A663-CE806 10/72 APPLICATION FOR ELECTRICAL PERMIT . COUNTY OF LOS ANGELES r �/ DEPARTMENT OF COUNTY ENGINEER ADDRESS «�� '•'' � /U fl�' BUILDING AND SAFETY DIVISION LOCALITY NEAREST FOR APPLICANT TO FILL IN CROSS ST. OUTLETS NO. EACH FEE OWNER OR _ - $ $ FIRM NAME _,�".1i"�./..,� ` .a. ,er ..G'• RECEPT.= MAIL � LIGHT ..+� TOTAL FIRST 20 .25 ADDRESS /�- CITY ..J�/Y�i +4,. TEL. NO. SWITCH=. ! OVER 20 .10 PLAN CHECK LIGHTING � TOTAL FIRST 20 ` .25 APPLICANT '7 OVER 20 10 ADDRESS FIXTURES, ;1 RESIDENTIAL APPLIANCES CITY TEL. No. PERMIT i r✓ / ,.^ RANGE DRYER_WTR, HTR. APPLICANT '�SS �"-"^•��.. »��"` STA. COOK DISP. F.A.U. ADDRESS SPACE HTR. AIR COND. CITEL. N0. TY4r— CLOTHES WASH. OISHWASH. LICENSE OR CLASS, REG..NUMBER FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION 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. P. KW. KVA. ELECTRICAL WIRING. SIZE & TYPE OVER TO ~ "'• I HEREBY CERTIFY THA.TI AM PROPERLY REGISTERED�AND/OR y. 0 — 1 .1.00LICENSED AS REQUIRED BY-LOS ANGELES COUNTY AND/STATE;:, 0•- CALIFORNIA OR THAT I,fAM THE LEGAL OFF T` ABOVE U 1 — 10 3.00 DESCRIBED RESIDE NT✓AL PROPERTY. f/'' Lu PERMITEE 10 — 50 5.00 SIGNATURE �-- • 50 — 100 10.00 DISTRICT NO. PROCESSED BY 100 — 500 15.00 3P c:) SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTOR'S SIGNATURE TUBE, OR MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE ' SERVI CENOTOVER 600 VOLTS OR 200 AMP 3.00 UNDERSLAB WORK - SERVICE'OVER600VOLTS OR200AMP 10.00 ROUGH CONDUIT , TEMP SERVICE,POLE, &APPURTENANCES 5.00 WIRING TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES „ POWER AUTHORIZED UTILITY CO. NOTIFIED FINAL PERMIT FEE (SUB TOTAL) NOTES, PLAN CHECK FEE PERMIT ISSUING FEE 3.00 TOTAL FEE PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH • 1 ) SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE Tec,-7se IGAeaa CEE094 EO APPLICATION FOR ELECTRICAL PERMIT 'Q COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING �.. BUILDING AND SAFETY DIVISION ADDRESS JOHN A LAMBIE. COUNTY ENGINEER WILLIAM A JENSEN SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST CROSS ST PERMIT FEES OWNER ITEM NUMBER EACH FEE MAIL OUTLETS „ ADDRESS LIGHTS RECEPT SW-4 10 / �C� LIGHTING FIXTUR S 10 30 CITY TEL O ELEC RANGES CLO DRYERS ELECTRICIAN WATER H EATERS s0 ADDRESS r ELEC SPACE HTRS DISHWASHERS CITY ! TEL NO / GARBAGE DISPOSERS AUTO STATE / /0 J WASHERS STA COOKING UNITS 2E LICENSE NO ((� rc. a MOTORS OVER INC H P // DISI�+ICQT d DR IP ZQNE PR CESSED BY O — V. 214 lfV —1 // (f� vs — 2 so INSPECTION RECORD 2 — 9 100 a 3 — 15 150 0 U Is — EO 250 w SO — 200 Soo O SIGNS NO TRANS d NO LAMPS N Z SERVICE O 600V 100 SERVICE OVER GOOV Soo MISC WIRING PERMIT 100 �-q FIXTURE PERMIT too lJ M SUPPLEMENTARY PERMIT S0 TOTAL FEE S 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT ELECTRICAL WIRING I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR WIRING LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PRO E Y LFINA SIGNATURE Y CO NOTIFIED OF PERM ITT E VALIDAT� CK MO CASH SUPERVISING ELECTRICAL ENGINEER UjCo55444 IIPR17 2 D 4.30 M ISA6as CE806400 APPLICATION FOR ELECTRICAL PERMIT 1 COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER =LOCALITYAQd=Ea- BUILDING AND SAFETY DIVISION JOHN A LAMBIE, COUNTY ENGINEER WILLIAM A JENSEN SUP T OF BUILDING FOR APPLICANT TO FILL IN NEAREST CROSS ST PERMIT FEES OWNER I TIE M NUMBER EACH FEE MAIL C'�_ n OUTLET $ $ Q ADDRESS yLC'M��--C LIGHTS RECEPT 6W 10 LIGHTING FIXTURES 10 G CITY TEL NO ELEC RANGES `IQ�DRYERB _ ELECTRICIAN a WATER H EATERS so ✓ Q ADDRESS ELEC SPACE HTRB DISHWASHERS CITY p;rTEL NO GARBAGE DIBPOSERB //� ,p WAS STA COOKING UNITS1 25 Q (� LICENSE NO MOTORS OVER INC H PIGDISTRI T N R P P ESSED BY O — 1/2 29 'i= — 2 so INSPECTION RECORD 2 S 100 s — 15 iso O V Is =50 2 s0 0 SO 200 Soo U NO TRANS LU SIGNS D- NO LAMPS Z SERVICE O 600V 100 SERVICE OVER 600V Soo MISC WIRING PERMIT 100 t1 FIXTURE PERMIT too O d SUPPLEMENTARY PERMIT S0 TOTAL FEE $ 3 1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING CONDUIT ELECTRICAL WIRING WIRING r S c.LO 1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES CALIFORNIA OR THAT 1 AM THrr LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENT kL PROP Y POWER SIGNATURE UTILITY CO NOTIFIED OF PERM ITTE FINA LIDATION ARTHUR C VEIT, CK MO CASH SUPERVISING ELECTRICAL ENGINEER L.f�o4 7 f031 2 a 7.30 rt � "- CBS SA 3-5O APPLICATION FOR PERMIT DEPARTMENT OFNG AND SAFETY , �� A COUNTY OFF LOS LOS ANGELES WILLIAM J. FOX, CHIEF ENGINEER FOR APPLIC�V TO FILL IN DISTRICT NO. GROUP ZONE PERMIT NO. ELECTRICI ( REC ED BY READY FOR DATE IBBUED ADDRE FIRST INSPECTION / CITY TEL.NO COUNTY LIC SE NO EXPIRES BUILDING e PERMIT FEES ADDRESS NUMBER EACH FEE LOCALITY LIGHT OUTLETS NEAREST CROSS ST. RECEPTACLES r 0 4- WALL SWITCHES OWNER TOTAL OUTLETS S. III MAIL ELEC RANGES 25 ADDRESS ELEC HEATERS 25 CITY TEL N .4- FIXTURES B 1 HERE ACK GE OE THAT 1 HAVE READ THIS MISC APPLICATI N AND 8 E THAT t. THE ABOVE IB 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 LICENS , OR 1 THE LEGAL OWNER NEW MvD HP OVER INC EACH OF THE RESIDENTI P ER CRIBED ABOVE. 6 LESS 1$ 25 SIGNATURE O I�2 2 50 PERMITTE 2 5 100 INSPECTION RECORD s is 1 so 15 50 250 s0 200 Soo 200 500 1000 Q 500 1000 1500 Z OVER 1000 2000 Q M O SET/FREQ CHANGER-HP WELDERS AC-KVA O GENERATORS - KW TRANSFORMERS - KVA TEMP MOTORB (75% OF GRID) e MOVED MOTORS (75% OF ORIa) MISC SIGNS NO NO TRANS APPROVALS NO NO LAMPS DATE INSPECTORIB NAME FOR EACH PERMIT WIRING $1 OO CONDUIT FIXTURES $100 WIRING SUPPLEMENTARY s0 FIXTURES POWER n TOTAL FEE III 6ol UTILITY CO NOTIFIED FINAL OBS 5A 3 SS APPLICATION FOR ELECTRIC PERMIT 1 DBS SA DIVISION OF BUILDING AND SAFETY a, Department of County Engmeer County of Los Angelos BUILDING /j WM J FOX, COUNTY ENGINEER ADDRESS n[ (!/ CASSATT D GRIrFIN SUP T OF BUILDING , zzaglimmamm LOCALITY FOR APPLICANT TO FILL IN NEAREST PERMIT FEES CROSS ST NUMBER EACH FEE OWNER 1 LIGHT OUTLETS MAIL ' RECEPTACLES ADDRESS WALL SWITCHES TOTAL OUTLETS 5¢ $ CITY TEL NO ELEC RANGES 25 ELECTRICIAN ELEC HEATERS 25 -ADDRESSJV KW EA CITY TEL NO jjT9� FIXTURES 5 LICENSE NO qg2[B NUMBER OF LIGHT CIRCUITS ' X - DISTRIC NO GROUP ZONE I READY FOR INSPECTION NUMBER OF RECEPTACLE CIRCUITS I / I MOTORS ti--,41 INSPECTION RECORD NUMBER HORSEPOWER FEE NEW MVD HP OVER I INC EACH 1/2&LESS $ 25 1/2 2 50 2 5 1 00 5 15 1 50 15 50 250 11 50 200 500 MISC NO SIGNS NO TRANS NO SIGNS NO LAMPS FOR EACH PERMIT WIRING $1 00 n FIXTURES $1 00 SUPPLEMENTARY 50 APPROVALS TOTAL FEE S I DATE INSPECTOR S SIGNATURE 1 HEREBY ACKNOWLEDGE THAT I,HAVE READ THIS APPLICATION CONDUIT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING ELECTRICAL WIRING 1HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR FIXTURES LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF .- CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE POWER DESCRIBED RESIDENTIAL PROPER T UTILITY CO NOTIFIED SIGNATURE OF PERMITTEE FINAL �r .1.( SJ el WILLIAM J FOX.COUNTY ENGINEER VALIDATION A C VEIT,CHIEF ELCCT INSPECTOR � 1 ,5-5 -7_Z9 -OCT 22 2 3.2 ��' t e _ 6-46 APPLICATION FOR PIGII3LCd.4Y PART�IENT.®F B� �� G ANDSELECTRIC� COUNTY OF LOS ANGELES WA/ ..J F(ak oEHIEF ENGINEER 0 Q NAME �� DISTRICT NO. GROUP ZONE PERMIT/NO. ADDRESS i .* W CITY ♦ j4Q TEL NO O RECEIVED BY READY FOR DATE ISSUED FIRST INSPECTION CERT NO 7 EXPIRES v A APPLICANT FILL ft-E- .Y OU'T'LINE® PORTION ONLY (DESCRIPTION OF WORD ADDRESS NUMBER OF OUTLETS ON CIRCUITS LOCALITY Y l LOCATION BY ROOMS NEAPEST LIGHT OUTLETS Isw PLUGS IFIXT CROSS ST CIRCUIT A B C I D I E F G IH Ir NAME Z MAIL _ 3 ADDRESS r CITY 1 AM THE LEGAL POSSESS R O T E ABOVE LOS ANGELES COUNTY CERT FTC OF IFICATION CTRICIA I AM THE LEGAL OWNER OR E PROPERTY DESCRIBED ABOVE /''� �y��q �+ Ja OWNER 1 `4®1�.8C9iVJ 18®. S W I- a v J a o TOTAL NO OF OUTLETS $ APPROVALS I NO OF FIXTURES $ DATE INSPECTOR'S NAME NO OF MOTORS H P $ CONDUIT i NO OF SIGNS TRANS $ WIRING OyQFaF.MNGE81Qg HEATERS LT $ � FIXTURES IISCELLANEOUS $ ` POWER ERMIT FEE 1 UTILITYCO NOTIFIED OTAL FEE i FINAL, WORKERS COMPENSATION DECLARATION -663 jo/aj AppL'ICATION,FOR ELECTRICAL 'PERMIT J� I CE hereby affirm that I have a certificate of consent to self insure CE-806G ; or a certificate of Workers Compensation Insurance, orl'a certified COUNTY OF LOS ANGELES ° BUILDING AND SAFETY c�(P�({�j��y�tyeyeof((Sec 800 Lab C) ° r POII O / Company FOR APPLICANT TO FILL IN _ • ,° JOB ADDRESS' ❑ +=Certified copy is hereby furnished New Residential Bldgs &Pools EACH NO FEER LOCALITY Certified copy is filed with the'county buildi inspection 1 & 2-Family Sq'Ft $ $ q dep rt n Multi-family Sq Ft CROSS ST, -43 J /r Apploant Date A ` V Residential Swimming`Pools OWNER OR,J r 117 F `< FIRM NAME ; b L;CERTIFICATE OF EXEMPTION FROM WORKERS MAIL , /r , , Outlets Rec` Light 'Sw , .. l COMPENSATION INSURANCE ADDRESS (This section need not be completed if the work involved by the . _ ` First 20 1 permit is for one hundred dollars($100)or less) - l,No Additional " CITY Tel No Tota F t ° , _ I certify that in the performance of the work for which h this permit APPLICANT' 4 is issued I shall not employ any person in any manner so as to become subject to the Workers Compensatiopn Laws Lighting Fixtures First 20} - 'ADDRESS t"' 1 ° Total No . Additional CITY ' Tel No Date Applicant NOTICE,,TO`APPLICANT If, after making ,this Certificate of Fixed Appliances Not Over 1 HP PERMIT e Exemption you should become subject to the,Workers Compensation Range_ Heater_ DW ° ~_ APPLICANT provisions oL the Labor Code you must+forthwith comply with such Oven _ DryerW M ADDRESS provisionslor this permit shall be deemed revoked Top FAU H CITY Tel No r= LICENSED CONTRACTORS DECLARATION a Hood — Fan ,_ Other_ SE OR I hereby affi`r'm that I am,licensed•under provisions of Chapter 9 Disp Room Air Cond e / REG NNu BER Class` (commencing with Section 7,000) of Division 3 of the Business and , Professions Code and my license is in Power Apparatus& Large Appliances full force and effect z DISTRICT N O ° PR SED ev 4Q A0 A Size& Type HP,KW,KVA or KVAR a t License Number (� i Lic ass / Up to 1 Incl aA FINAL U Over 1 to 10 Incl DATE/J - Contractor Date f 7 D VALIDATION , � ❑ a , Over 10 to 50 Incl M1 FINAL V a I am exempt under Sec Over 50 to 100 Inc BY „ z ' W B&P C for this reason Over 100 "Services Swtid-MCC& Panelboards "' � r N `Date 0- 200 Amp Under 600 V Signature 201 - 1000 Amp Under 600 V - Over 1000,Amp or Over 600 V " + Exemption for'Reg Maint Elect , SINGLE FAMILY Temp Power Pole& Appurtenances, " HOME OWNER-BUILDER DECLARATION ' Sign with One Branch Circuit. I hereby affirm that I am exempt from the Contractors License Law ircui Additional Sign Branch Cts - Y for the following reason(Section 7031 5 Business and Professions 3Ji'� "e ij a Code) ,i ' 27.0 ❑ Misc Conduits& Conductors ^, 1 ITErF, — 1 as owner of,the property will do the work and the structure s not intended or offered for sale (Section 7044 Business Other(See Complete Fee Schedule) e TOTAL m and Professions Code) j ° CHECK i , 7 C► CONSTRUCTION STRUON LENDING AGENCY `" T I hereby affirm that there is a construction lending agency for the " lW14GE 1 , e�l� performance of the work for which this permit is issued(Sec 3097 ,, PERMIT`FEE t' " '' -(Sub-Total) Civ C) , - , , r ,I %, , e PLAN CHECKING FEE " '^ 0►��( `1�C11y. 5/ L1 Lenders Name ' " PERMIT ISSUING FEE " 42-0 - -1 av 11�;y y Lenders Address Z I certify that I have read this application and state that the above TOTAL'FEE information is correct I agree to comply with all County ordinances and State laws regulating Electrical wiring and hereby authorize representatives of this,County to enter upon the`above-mentioned ` Pr spechon purposes ; SEE REVERSE FOR EXPLANATORY LANGUAGE S ature o PeTimittee Dae , w COMPENSATION DECLARATION 76A663 10/81 APPLICATION FOR ELECTRICAL PERMIT Ihe�e�yt I have a certificate of consent to self nsureote,of Workers Compensation Insurance COUNTY OF LOS ANGELES BUILDING AND SAFETY or a fertrfied cops thereof (Sec 3800 Lab C ) Policy No Company FOR APPLICANT TO FILL IN JOB v� ❑ Certified copy is hereby furnished New Residential Bldgs & Pools EACH NO FEE ADDRESS ❑ Certified copy is filed with the county building inspec- 1 & 2-Family, Sq Ft $ — $ LOCALIT ,tWJ1' e>, tion department Multi-family Sq Ft NEAREST LIP CROSS ✓e.. Residential Swimming Pools OWNER OR Date Applicant _ FIRM NAME N CERTIFICATE OF EXEMPTION FROM WORKERS Outlets Rec Light Sw_ ADDRESS` D✓E,x COMPENSATION INSURANCE First 20 ADDRESS y 61 (This section need not be completed if the work involved by Total No Additional CIT I` 1 �" Tel o ` , fq the permit is for one hundred dollars (:100)or less ) _ I certifythat in the of the work for which this r PLAN CHECK e performance APPLICANT permit is issued I sh of employ any person in any manner so as to become subject to Workers Compen aws Lighting Fixtures% First 20 ADDRESS Total No Additional CITY Tel Date nt x antes Not Over 1 HP T NOTICE TO APPLIC after making s Cert ate of PERMIT APPLICANT Exemption, you should become subject to the-Workers Range_ Heater,D W _ Compensation provisions of the Labor Code you must forth- Oven _ Dryer — W M — ADDRESS with comply with such provisions or this permit shall be Top _ FAU —W H — deemed revoked Hood Fan _Other_ CITY Tel No LICENSED CONTRACTORS DECLARATION LICENSE OR I hereby affirm that I am licensed under provisions of Chapter 9 Disp _ Room Air Cond REG NUMBER Class (commencing with Section 7000) of Division 3 of the Business Power Apparatus & Large Appliances DISTRICT NO PROCESEP BY and Professions Code and my license is in full force and effect Size &TypeHP KW KVA, or KVAR 0 _ O License Number Lic Class Up to 1 Incl FIN V Over 1 to 10 Incl D �� VAL ATION 09 Contractor Date Over 10 to 50 Incl I :7FINAL V F1am exempt under Sec Over 50 to 100 Inc Over 100 BY y W B&P C for this reason � , Services Swbd-, MCC& Panelboards J Z Date 0 200 Amp Under 600 V Pool/M Se / g 7 8 5.3 A Signature 201 1000 Amp Under 600 V - F1Exemption 1000 Amp or Over 600 V # 0,0 o 0 0 2 Exemption for Reg Maint Elect I'- ° 2 5.5 0 SINGLE FAMILY Temp Power Pole & Appurtenances HOME OWNER BUILDER DECLARATION c c e 2-5505 Sign with One Branch Circuit I hereby affirm that I am exempt from the Contractor s License Additional Sign Branch Circuits Law for the following reason (Section 7031 5 Business and 09, 08-87 Xss,ons Code) I as owner of the property will do the work and the Misc' Conduits& Conductors structure is not intended or offered for sale (Section Other (See Complete Fee Schedule)- 7044 Business and Professions Code) CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued PERMIT FEE - ,(Sub-Total) (Sec 3097 Civ C ) PLAN CHECKING FEE r Lender s Name PERMIT ISSUING FEE Lender s Address I certify that I have read this application and state that the TOTAL FEE (/ above information is correct I agree to comply with all County ' ordinances and State laws regulating Electrical wiring and hereby au resentatives of this County to enter upon `the above-mentione operty for inspection purposes ' - SEE REVERSE FOR EXPLANATORY LANGUAGE 1 Signature P tree Date S J ' f COUNTY OF LOS ANGEL.- TEMPLE CITY # 0508 { ELECTRICAL PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS EL 0508 9810130052 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE (818) 285-0488 EXT LEGAL ID ES PAID BUIL G A SS ON FILE 5426 CLOVERLY AV FEE DESCRIPTION QUANTITY UOM AMOUNT TEMP CA 917803107 ASSESSOR INFORMATION NUMBER 4 NEAREST CROSS STREET BROADWAY 8588-026-005 Al PERMIT ISSUANCE FEE 27 75 THOMAS PAGE 596 GRID J4 LOCALITY TEMPLE CITY 01 OTHER INSPECTIONS 1 00 HOU 109 35 E TENANT TOTAL FEES 137 10 SUED ON PROCESSED BY PLANEXPIRES 0 10/11/98 UT 10/13/99 1 OWNER TEL NO FINAL DATE FINAL BY CODE ARTHUR MAXINE F TRUSTEE,ARTHUR MAXI - a of DES RIP 0 INSPECTION OF SWIMMING POOL PER HEALTH DEPT SENATE 873 APPLICANT TEL NO G E SHEARS ELECTRIC (626) 351-1902- SPECIAL CONDITIONS GE,LES Co _ CONTRACTORELECTRIC TEL(626)N351-1902- �� P� APPROVALS DATE INSPECTOR SIGNATURE 1075 CORONET AVENUE LIC NO TEMPbRARY POWER POLE PASADENA, CA 91107 445988 C10 UNDERGROUND CONDUIT ARCHITECT OR ENGINEER TEL NO UFER GROUND LIC NO 1111111 ROUGH CONDUIT RO0G11 WIRING U n L (C W O n K 3 MAIN WATER LINE vL'08') w PLASTIC Y/N METAL Y/N UTILITY COMPANY NOTIFIED - 0 O 0 J Pi kt fid%c n Service lea REPORT ID DPR265 ROUTE TO SS0508