HomeMy Public PortalAbout6020 LOMA AVE_Electrical__ 76A663-�:E80610'72 APPLICATION FOR ELECTRICAL P, MIT
_COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER JOB 5020 Loma
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BUILDING AND SAFETY DIVISION ADDRESS
LOCALITY Temple City
NEAREST Gari3ildi
FOR APPLICANT TO FILL IN CROSS ST.
OUTLETS NO. EACH FEE OWNER OR
$ $ FIRM NAME Farmer
RECEPT._ MAILS 5020 LomaFI RST 20 .25 pp p
LIGHT TOTAL CITY Temple City TEL. NO.'2C)5-9574
SWITCH - ,OVER 20 ;10
PLAN CHECK
LIGHTINGFIRST 20 25 APPLICANT '
TOTAL ADDRESS
FIXTURES OVER 20 10
RESIDENTIAL APPLIANCES CITY TEL. NO,
PERMIT C. W; GA-RTSIDE ELECTRIC
RANGE DRYER_WTR. HTR. APPLICANT
STA. COOK DISP. F.A.U. i ADDRESS 533 N.�Angeleno Ave.
SPACE HTR. AIR COND. CITY Azusa Calif.if. TEL. NO. 7 9-222
CLOTHES WASH, DISHWASH. �. REG. NUMBER CENSE OR2O4 2H CLASS. C-10
FAN OTHER 1.00 C) I 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. HP. KW. KVA. ELECTRICAL WIRING.
SIZE & TYPE OVER TO
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 - 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OFA
'CALIFORNIA OR THAI I AM THE LIGAL OWNER OF THE ABOVE
/'i'CS DESCRIPED RESIDENTIAL PROPERTY d
1 — 10 f 3.00 CJ CD
10 — 50 5.00 -PERMITEE Ti U
SIGNATURE
O
50 — 100 10.00 v
DISTRICT N0. PROCESS D,BY La.i
100 500 15.001
Ale Z
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 APPROVALS DATE INSPECTORSSIGNATURE
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 TEMP. POWER POLE -
SERVI CE NOT OVER 600 VOLTS OR 200 AMP 3.00 DV UNDERSLAB WORK
SERVI CE OVER 600 VOLTS OR 200 AMP 10.00 ROUGH CONDUIT
TEMP SERVICE,POLE, &APPURTENANCES 5.00 WIRING -
TEMP LIGHT OR RECEPT. SYSTEM 3.00 FIXTURES
IF
R AUTHORIZED
TY CO. NOTIFIED
PERMIT FEE (SUB TOTAL) S:
PLAN CHECK FEE
PERMIT ISSUING FEE 3.00TOTAL FEE
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION` CK. M.O. CASH
I Ar, 1 7 3 1'. JAN 18 2 D 1. 0.0 ON
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE