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iA66S-CES06 5-62 APPLICATION FOR ELECTRIC/AL PERMIT
.61 . COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER FB
UILDING
BUILDING AND SAFETY DIVISION DDRESSZZZJOHN A. LAMBIE. COUNTY ENGINEER
WILLIAM A.JENSEN,SUPT OF BUILDING CALITYEARESTFOR APPLICANT TO FILL IN ROSS ST.
RECEPT. • v TOTAL NO. EACH FEE *`
OUTLETS FIRST 20 111.20 OWNER
LIGHT &' MAIL
ADD'LADDRESS
SWITCH.I 3 OVER 20 .t0 91
LIGHTING
TOTAL FIRST20 .20
D CITY TEL.NO.
/
FIXTURES /y ADD'L 1O ELECTRICIAN
J OVFR 20
RANGER CLO.DRYERS WTR.HTRB, 1.00 ADDRESS �� V
• ARB.DI STA.COOK CITY �fTEL.NO.
D18HWASH. AUTO.-WASH. STATE
LICENSE NO.
SPACE HTRS. A.APP.(ya X.P.MAX. -3 .50
MOTORS: OVER NOT OVER H.P. DISTRI T GR E P D
O 1 1.00 �1
I a 1.50 INSP TION RECORD
a s 2.00
s to 2.50 a
is so 3.00. 0
50 t00 5.00 O
SIGNS: NO.TRANS. V
NO.LAMPS
W
o_
SERVICE O.600V-NOT.OVER 200A 1.00 N
z
SERVICE O.600V•OVER 200 A. 2.00
SERVICE OVER 60 OV 5.00
MISC.
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00
TOTAL FEE
ID'HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION APPROVALS DATE INSPECTOWS SIGNATURE
AN STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING j,
ELECTRICAL WIRING. WIRING _J'! o X 63
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR y-
LICENSED A8 REQUIRED BY LOS GELES COUNTY AND STATE.OF FIXTURES
CALIFORNIA OR THAT 1 M T LEGAL NER OF THE ABOVE
DESCRIBED REBIDENTI P O Y. POWER ! • 1..��
f:.
SIGNATURE Ae UTILITY CO.NOTIFIED .0/41 I f?
OF PERMITTEE FINAL r r �/: ✓'.'� v
,,"LIDAIION ARTHUR C.VEIT
MID
MO CASH SUPERVISING ELECTRICAL ENGINEER
U:,;o.,00530AN23 2D 13t6ONX
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS
EL 0508 0902120022
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I FEES PAID I BUILDING ADDRESS: 1
ON FILE I I 6218 OAK AV 1
I FEE DESCRIPTION: QUANTITY: DOM: AMOUNT:( TEMP CA 917801655 1
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LONGDEN
15385-010-026 IA1 PERMIT ISSUANCE FEE 27.75 I THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY, Cl
I JHA FAD LESS 314P 1.00 FAD 10.95 [ 1
IT T: JB AC UNITS +3-10HP 1.00 AC 19.65 JISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 1
I ILA 100 AMP PANELS, MCC 1.00 PAN 38.85 102/12/09 SR 08/11/09 [
I TOTAL FEES 97.20 1 I
(OWNER: TEL. NO: IFINAL DA FINAL BY: CODE:
ICHEN, PAI CHOU (626) 451-6962-
16218 OAK AV I I
1TEMP 917801655 1 IDESCRIPTION OF WORK 1
I I IAELEPCTRICAL FOR HVAC SYSTEM AND UPGRADE SERVICE PANEL TO 100
M [
JAPPLICANT: TEL. NO: J
ISAME AS OWNER _ [ 1
J I (SPECIAL CONDITIONS:
I
I I I
[CONTRACTOR: TEL. NO: J JAPPROVALS DATE INSPECTOR SIGNATURE
ISAME AS OWNER _ I I
ILIC. NO I (TEMPORARY POWER POLE I 1
I I IUNDERGROUND CONDUIT
JARCHITECT OR ENGINEER: TEL. NO: [ IUFER GROUND I I I
LIC. NO: 1 (ROUGH CONDUIT b I I
(ROUGH WIRING II I
IMAIN WATER LINE
J I (PLASTIC YIN METAL YIN I I
(UTILITY COMPANY NOTIFIEDol
I
I I I I 1 I
I I I
I I I i I I
I I J I 1 I
I 1 I I I I
I I I I
I 1 1 I I I
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(REPORT ID: DPR265 ROUTE TO: BS0508 [ I [ I
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