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'6A663-CER06 5-62 APPLICATION FOR ELECTRIC IS PERMIT
- ' ' CAONTY 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
NEAREST �—
FOR APPLICANT TO FILL IN CROSS ST. /
RECEPT. 1I TOTAL NO. EACH FEE
� OUTLETS (FIRST 20 $
2O S ro0 OWNER
LIGHT 1 ` Q MAIL
A DD'L 10 ADDRESS
SWITCH. / OVER 20
TOTAL 0 H CITY TEL. NO.�� /��_
LIGFITING / F1Rsr 20 .20 LJ
FIXTURES J DV DA ZO 10 ELECTRICIIAN/J'C
RANGES CLO.DRYERS WTR.HTRB, 1.00 ADDRESS✓C��J U
GARB.DISP. STA.COOK
CITY TEL. NO. Q 6
DISMwnsH. AUTO.-WASH. STATE
SPACE HTRB. STA.APP.(y.M.P.M".) .50 LICENSE NO. O �/
MOTORS: OVER NOT OVER N.P. DISTRICT NO. I GR UP I ZONE I P O ESSjE D B
0 1 1.00
f — s 11.50 INSPECTION RECORD
s — e 12.00 1-
8 f s 2.501 i
15 50 3.00 0
50 100 5.00 C
O
SIGNS: NO.TRANS.
NO. LAMPS W
SERVICE O-000V-NOT OVER 200A 1.00 h d
Z
SERVICE O-BOOV-OVER 200 A. 2.00
SERVICE OVER SOOV 5.00
MISC.
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE $
Q
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOR'S SIGNATURE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY -CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING. WIRING LIX
a )
1 HEREBY CERTIFY THAT 1 S PROPERLY REGISTERED AND/OR
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF FIXTURES
CALIFORNIA BI THAT M THE LEGA D ER OF THE ABOVE
DESCRIBED RESIDENT( ROPERTY. POWER
SIGNATURE UTILITY CO.NOTIFIED 919/f.�
OF
FINAL 7
VALIDATIQN� ARTHUR C. VETT
CK MO SUPERVISING ELECTRICAL ENGINEER
07 9 4 3'G JAN 27 2 D 7.80-
1
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 1302210047
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: FEES PAID BUILDING ADDRESS:
ITR: 14467 LT: 76 BL: .001 1 9642 LA ROSA DR
I IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT: 1 TIME CA 917803860
(ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET: TEMPLE CITY
16589-017-023 1A1 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY CAI
I ILA 100 AMP PANELS, MCC 1.00 PAN 38.90
T£NANT: TOTAL FEES 66.70 (ISSUED ON: PROCESSED BY: PLAN BY: 1
102/21/13 SR
I
OWNER: TEL. NO: IFIINNAL.�DA FIN �Y: CODE:
]LUCIANALEX;LYDIA G � /
9692 LA ROSA DR
TEMP 917803860 IDESCRIPTION OF-WORK
JDPGRADE SERVICE PANEL TO 100 AMP
APPLICANT: TEL. NO:
HONG, DAVID (818) 625-4227-
15238 LA MADERA AVE ISPECIAL CONDITIONS: 1
IEL MONTE CA 91732
I I
(CONTRACTOR: TEL. NO: I
(APPROVALS DATE INSPECTOR SIGNATURE
IN! NO ELECTRIC CO (818) 625-9227- 1_
15238 LA MADERA AVENUE LIC. NO ITEMPORARY POWER POLE I I
IEL MONTE CA 91732 670353
I (UNDERGROUND CONDUIT
(ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND 7R
K6 Y
LIC. NO: IROUGH CONDUIT
I I �
ROU(3H WIRING
(MAIN WATER LINE
IPLA.STIC YIN METAL YIN
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(UTILITY COMPANY NOTIFIE,, �
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IREPORT ID: DPR265 ROUTE TO: BS0508
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