HomeMy Public PortalAbout5647 PAL MAL AVE_Electrical__ 70A653-C.BOG 3-89 (L=M PL Ly L i -r y-
APPL'ICATION FOR ELECTRICAL (PERMIT
COUNTY OF LOS ANGELES
A DEPARTMENT OF COUNTY ENGINEER BUILDING I
BUILDING AND SAFETY DIVISION ADDRESS S6 AIL- ( L_
JOHN A LAMBIE COUNTY ENGINEER
COLEMAN W JENKINS SUPERINTENDENT OF BUILDING I LOCALITY
FOR APPLICANT TO FILL IN NEAREST
CROSS ST
NO EACH FEE
S E OWNER
RECEIPT J MAIL
LIGHT I TOTAL FIRST 20 20
!O ADDRESS
SWITCH Z' OVER 20 tp f0 CITY TEL NO
PLAN CHECK
LIGHTING TOTAL FIRST 20 20 APPLICANT
FIXTURES } Z OVER 20 10 ADDRESS
CITY TEL NO
RANGE_DRYER_WTR HTR _ �r
STA COOK_DISP _F A U CONTRACTOR � LC`
SPACE HTR LAIR COND ADDRESS 3 SCJ
CLOTHES WASH _DISHWASH /( .hh CITY � TEL NO
FAN_OTHER / 1 00 ( U O LICENSE NO 1 O d U
S CLASS C
MOTORS TRANSFORMERS RATING ( HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
IND HEATERS ETC HP KW KYA AND
STATE THAT THE ABOVE IB COIIRECT AND AGREE TO COMPLY
SIZE & TYPE OVER TO WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING
ELECTRICAL WIRING
D - 1 1 00 1 HEREBY CERTIFY THAT I AM PROPERLY REGISTERED PND/OR
LICCNSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
1 - 10 3 DD CALIFORNIA OR THAT I AM THE LEGAL OWNER OF AND INTEND TO Q
RESIDE IN THE AS BY
CRISES RESIDENTIAL PROPERTY u
10 - 50 5 00
SIGNATURE Q
50 - 100 10DO OF PERMITTEE
100 - S00 15 00 DISTRICT HO GRo zoN PR c e r
n n
SIGN GAS SIGN AND ONE CIRCUIT 3 00 A L! ' Atn Z
TUBE OR
MARQUEE ADDITIONAL CIRCUITS 1 00 NOTES
SERVICE NOT OVER 600 VOLTS OR 20OAMP 2 00
SERVICE OVER 600 VOLTS OR 200 AMP 5 00
TEMP SERVICE, POLE, &APPURTENANCES 3 00 APPROVALS DATE IRSPECTORI sI.TL.E
TEMP POWER POLE
UNDERSLAB WORK
ROUGH CONDUIT
WIRING ✓/� A � g(�Ff
�Q Z b1
PERMIT FEE (SUB TOTAL) FIXTURES
PLAN CHECK FEE (50%. PERMIT FEE) POWER AUTHORIZED
PERMIT ISSUING FEE 2 00 UTILITY CO NOTIFIED
F
SUPPLEMENTARY PERMIT ISSUING FEE 1 00 INAL
TOTAL FEE JO EPH C ROOHAN
SUPERVISING ELECTRIC ENGINEER
PLAN CHECK VALIDATION CN M 0 CASH PERMIT VALIDATION CK M O CASH
JAC, 5 4 4 39 Ml 7 2 D 5.00~
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE
C �L
V r C1111�
76AG6AE lOp NF 8/70 APPLICATION R ELECTRICAL PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLICANT TO FILL IN ADDRESS Ave
New Residential Bldgs &Pools EACH NO FEE
1 &2 Family Sq Ft b — E LOCALITY Tem e Cit
Multi for ly Sq Ft — NEAREST `
Residential Swimming Pools ROSS WNE R
FIRM NAME
MT• & Mrs. Tudor
Outlets Rec—Light�Sw MAIL
First 20 ADDRESS 5647 Pal Mal Avenue
Total No Z� Additional CITY Temple City Tel No 3 1
PLAN CHECK
APPLICANT
Lighting Fixtures First 20 ADDRESS
Total No Additional
CITY Tel No
Fixed Appliances Not Over 1 HP PERMIT -
Range—Heater— D W _ APPLICANT AAA Gondit3,oned
Air
Oven—DryerWM— ADDRESS 10160 Valley Blvd. -
Top —FAU Z W H _ CITY El _Monte Tel No 5?9 1800
Hood_Fan —Other— LICENSE MORER 22 Class C20
Disp —Room Air Cold REG NUB
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICA
Power Apparatus&Large Appliances TION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO
Sae&Type HP KW KVA or KVAR COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS y
YP REGULATING ELECTRICAL WIRING h.
Up to I Incl I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR C
Over 1 to 10 Incl LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF V
Over 10 to 501nd CALIFORNIA OR i T I AM THE LEGAL OWNER OF THE ABOVE
DESCRIBED RESID it PROPERTY Q
Over 50 to 100 Inc
PT
Over 100 SIGNATURE RE
Services DISTRICT NOQ PROC SED BY
0 200 Amp Under 600V Q G s
201 1000 Amp Under 600 V / (/ -
Over 1000 Amp or Over 600 V Z
O
Temp Power Pole&Appurtenances
Sign with One Branch Circuit
Additional Sign Branch Circuits I INSPECTION >
Misc CondunsBConductors INFORMATION
ON REVERSE x 3 9 5 5,6 A
Other(See Complete Fee Schedule)_ SIDE u
2 • • 1100
PERMIT FEE (Sub Total) ' . 1 1,006
Z
PLAN CHECKING FEE (One Fourth Permit Feel O O a 2 6_8 0
PERMIT ISSUING FEE D
a
TOTAL FEE I r '— >
INSPECTION FINALED
date ��Z� ?c BY