HomeMy Public PortalAbout5706 CLOVERLY AVE_Electrical__ Temple City
76A663 CE606 468 APPLICATION FOR ELECTRICAL PERMIT
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
"LM"BIE
AFETY DIVISION ADDRESS 5706 Cloverl Ave.
JOHCOUNTY ENGINEERCOL SUPERINTENDENT OF BUILDINGLOCALITY Temple Cit
I ]
FOR APPLICANT TO FILL IN NEAREST
CROSS ST Live Oak Ave.
NO EACH FEE
$ $ OWNER Danylevsky
RECEPT _ MAIL
LIGHT TOTAL FIRST 20 20 ADDRESS Same
SWITCH_ OVER 20 10 CITY TEL NO
PLAN CHECK
LIGHTING 1 TOTAL FIRST 20 20 APPLICANT
FIXTURES Jj OVER 20 10 gDDRESS
RANGE_DRYER_WTR HTR _ CITY TEL NO
STA COOK_DISP _F A U — CONTRAC FOR Santa. Anita Electric & e CO
SPACE HTR AIR COND ADDRESS 134 E Live Oak Ave.
CLOTHES WASH -DISHWASH CITY Arcadia TEL NO 66161
FAN-OTHER 1 00 LICENSE 1.10 2h5793 CLASS C_10
MOTORS TRANSFORMERS RATING
IND HEATERS ETC HP KW KVA I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
SIZE & TYPE OVER TO AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
0 - 1 1 00 (ELECTRICAL WIRING T C jJ� O 33
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
1 - 10 3 00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE LEg AL OWNER OF AND INTEND TO
10 - 50 S 00 RESIDE IN THE ABO DE ED RESIDENTIAL PROPERTY
50 - 100 10 00 SIGNATURE CL
OF PERMITTEE
U
100 - 500 15 00
DISTRICT NO GR P ZONE P D p
SIGN
TUBE A SIGN AND ONE CIRCUIT 3 00 V
W
MARQUEE ADDITIONAL CIRCUITS 1 00 NOTES O_
N
Z
SERVICE NOT OVER 600 VOLTS OR 200 AMP F 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
PERMIT FEE (SUB TOTAL) WIRING
FIXTURES
PLAN CHECK FEE (50% PERMIT FEE)
POWER AUTHORIZED
PERMIT ISSUING FEE 2 00 UTILITYCO NOTIFIED,
SUPPLEMENTARY PERMIT ISSUING FEE 1 00 FINAL
TOTAL FEEJOSEPH C ROOHAN
��IIMMI�016&jo SUPERVISING ELE CAL ENGINEER '
PLAN CHECK VALIDATION CK M 0 CASH PERMIT VALIDATION CK M 0 CASH
{1 1 3 3.3" AW 6 2 0 4.00~ CQ
EE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE