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DBS-SA 1f•89 APPLICATION FOR ELECTRIC PERMIT
DBS-SA
DIVISION OF BUIEDING AND SAFETY
Dep071>aent of County Engineer + BUILDING �®
County of LOS Angeles ADDRESS 57% 2.5 4 ` /Va
JOHN A.LAMBIE,COUNTY ENGINEER r
CASSATT D.GRIFFIN,SOOT OF BUILDING LOCALITY �g"��(� /P�
FOR APPLICANT TO FILL IN NEAREST
pERICT FEES ceoss Sr. /°-► e to a* S L:
NUMBER q � m o
OWNER ® v ILP
LIGHT OUTLETS MAIL
- g] q�J
r RECEPTACLES ADDRESS e7. 2-9-S' �' /`� NO
WALL SWITCHES FEE CITY 119 � �� TEL.NO.
TOTAL OUTLETS 5¢ $ 1.90
�1
ELECTRIC AN v r [s Qr+v Cv
ELEC.RANGES 25 ADDRESS ® V @ 7'
ELEC.HEATERS 25 r
KW EA CITY 4e / TEL.IVO. o"
FIXTURES S ® STATE lJrocv
LICENSE NO. 7 ((DD p '7T
MOTORS DISTRICT NO. GROUP ZONE I READY FOR INSPECTION
NUMBER HORSEPOWER FEE
NEW MVD. HP OVER INC. EACH f f�f, � PSC ON RECORD
a rA ]h s LESS $ .25 - i i1LW^" I
if2 2 .50 TZ2
I 2 5 1.00 r
5 1 i5 1.50
15 SO 2.50 -
50 200 5.00 ALE/ &0
lASJ.�1..rs �� !'4 r 6.7�� 1i4.��l�;3•I�..'�
MISC. b ,>.- o -f— x
- v 4
�,
NO.SIGNS NO.TRANS. z
NO.SIGNS NO. LAMPS
FOR EACH PERMIT:
WIRING $1.00 ®�
FIXTURES $1.00 ®® '
SUPPLEMENTARY .50
p APPROVALS
TOTAL FEE $ Y 0
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION DATE INSPECTORS SIGNATURE
AND STATE THAT THE ABOVE 13 CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING i•� �d+fs �t i• �, I; '
ELECTRICAL WIRING.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR FIXTURES
LICENSED AS REQUIRED BY LOS ANGELES COUN .AND STATE OF
CALIFORNIA OR THAT I AM THE LEGAL OWN OF THE ABOVE POWER.
DESCRIBED RESIDENT14L EROP -�' . UTILITY CO.NOTIFIED
P$ RE
TU
.��?. �j �► /: �- I ,. .y.; !''r
SOF RMIITEE i
iOHN A.LAMBIE.COUNTY ENGINEER ANION ARTHUR C.VEIT.CHIEF ELECT.INSPECTOR ;
/� MO CABH
3 2. 7 5 L-° 6EC 12 2 4.10
75A653-CE'806 1 70 APPLICATION" FOR ELECTRIC L PERMIT
� IC�OUNTY OF LOS ANGELES
D B CDII�N,G AND SAFE YYDIV SIONER ABUIL 1 6-3 I /O �.•
OHN ANL'AMBIE. COUNTY ENGINEER LOCALITY C>'
COLE WW W. JIj'NKIA ,,SUPERINTENDENT OF BUILDING
NEAREST
FOR APPLICANT TOIFILL IN CROSS ST.
OUTLETS NO. EACH FEE V� e C Y412 b
RECEPOWNER (' L �/'lU w� j �J
AIL
LIGHT ._ $ $ ADDRESS.) J X ,r / /
LIGHT TOTAL FIRST 20 .20 G�(y
SWITCH OVER 20 10 CITY G I/®lb. V I TEL. NO.
PLAN CHECK
LIGHTINGTOTAL .10 FIRST 20 .20 APPLICANT
FIXTURES
OVER 20 ADDRESS
APPLIANCES CITY TEL. N0.
MI /• /' /�
RANGE DRYER_WTR. HTR. PERM
ERAPPLICT ANT J fi V �✓
STA. COOK DISP. F.A.U. ADDRESSI , 4
SPACE HTR. AIR COND. CITY AM elf 0,1,4 TEL. NO.-dl -- O
CLOTHES WASH. DISHWASH. LICENSE NO. CLASS.
FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE.ABOVE 15 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
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED AND/OR
0 - 1 100 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM T LEGAL OWNER OF, A INTND TO
1 - 10 3.00 RESIDE N. THE ABOVE SCRIB RESIDENTI PROPEERTY.
SIGNATURE
'' a
10 - 50 5.00 OF PERMITTE f O
V
50 - 100 10.00
DISTRICTNO. CLASSGROUP ZON 0 SSE B 0
100 - 500 15.00 ��op -�/ �( `, 0
SIGN, GAS SIGN AND ONE CIRCUIT 300 NOTES: W
TUBE, ORIQ G «J h
MARQUEE ADDITIONAL CIRCUITS 1.00 J z
SERVICENOTOVER600VOLTSOR200AMP 2.00 o Z
SERVICEOVER 600 VOLTS OR200AMP 5.00 APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP.POWER POLE
TEMPSERVICE,POLE,&APPURTENANCES 3.00
UNDERSLAS WORK
TEMP LIGHT OR RECEPT. SYSTEM 3.00
ROUGH CONDI UT
WIRING
PERMIT FEE (SUB TOTAL) FIXTURES
PLAN CHECK FEE (50°l6 PERMIT FEE) POWER AUTHORIZED ..J
UTILITY CO. NOTIFIED
PERMIT ISSUING FEE 2.00
SUPPLEMENTARY PERMIT ISSUING FEE 1.00 FINAL
JOSEPH C. ROOHAN
TOTAL FEE O SUPERVISING ELECTRICAL ENGINEER
PLAN CHECK VALIDATION CK. M.0. CASH PERMIT VALIDATION CK. M.O. CASH
I AP. u 16 1� PAY10 2 D 4.00" �=
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 FECECTRTCAI-PERM-IT�
8-
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ELr0509809.080038)
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA
PHONE: (818) 285-0488 EXT:
EGA ID: FEES PAID BUILDING ADDRESS:
TR: 12205 LT: 3 l�5n7-PAL-MAL-A
FEE DESCRIPTION: QUANTITY: UDM: AMOUNT: TEM9978034
P CA
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: FREER
8585-022-004 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY
01 OTHER INSPECTIONS 1.00 HOU 109.35
TENANT: TOTAL FEES 137.10 ISSUED ON: PROCESSED BY: PAN BY: EXPIRES ON:
09/08/98 UT 09/08/99
OWNER: TEL. NO: FINAL DATE FIN CODE:
MUNOZ VICENTE M (818) 443-7508-
5225 PAL MAL AV
TEMP 917803436 DESCRIPTION UP WURK
�ItNSPECT-I.ON•'FORSWIMMING P ER HEALTH DEPT. SENATE BILL
873
PPLICANT: TEL. N0:
SAME AS OWNER -
SPECIAL CONDITIONS:
CONTRACTOR: TEL. N0: ,; ` APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER -
LIC. NO .� - TEMPORARY POWER POLE
- UNDERGROUND CONDUIT
ARCHITECT OR GINEER: TEL. NO: - FER GROUND
LIC. NO: _ ROUGH CONDUIT
ROUGH WIRING
MAIN WATER LINE
PLASTIC Y/N METAL Y/N
- - UTILITY COMPANY NOTIFIED
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REPORT ID: DPR265 ROUTE TO: SS0508