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DOS-13A 11.88 APPLICATION FOR ELECTRIC PERMIT 1
DrMION OF MWING J= SIaiFETY
Depambunt of County Eng1wes BUILDINGSt OF
County of Los Angeles ADDRESS S.7
JOHN A.LAMBIE,COUNTY ENGINEER
CASSATT D.GRIFFIN,SUPT OF BUILDING LOCALITY
FOR APPLICANT TO FILL IN NEAREST
PEMT FEES c OSS ST.
NUMBER OWNE
LIGHT OUTLETS MAIL
RECEPTACLES ADDRESS
WALL SWITCHES FEE CITY T O.
TOTAL:OUTLETS ® 5¢ $
ELECTRICIAN
ELEC.RANGES 25 Z
ADDRESS S
ELEC.HEATERS 25
ICi�/ CITY EL.NO. -
STATE
FIXTURES 5 LICENSE NO. Cv
MOTORS DISTRICT NO. GOUP ONE READY FOR 1NSPECTSoN
NUMBER HORSEPOWER FEE IR) •_
NEW MVD. HP OVER INC. EACH
a LESS $ .25 INSPECTION EECOBD r
1 2 .50
2 5 1.00
5 15 1.50
15 50 2.50
50 200 5.00
MISC.
NO.SIGNS NO.TRANS.
j NO.SIGNS NO. LAMPS
FOR EACH PERMIT:
WIRING $-1.00 U 0
FIXTURES $1.00
•. SUPPLEMENTARY .50
APPROVALS
TOTAL FEE 8 DATE INSPECTOR'S SIGNATURE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION I
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY CONDUIT
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING WIRING
i ELECTRICAL WIRING.
I HEREBY 'CERTIFY THAT.I AM PROPERLY REGISTERED AND/OR FIXTURES.
LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF
CALIFORNIA OR THAT I AM THE UWAL QVNER OF THE ABOVE POWER
DESCRIBED RESID PER
SIGNATURE UTILITY CO.NOTIFIED I7r
OF PERMITTE FINAL 1® '� 7771
JOHN A.LAMBIE.COUNTY ENGINEER VALIDATION ARTHUR C.VEIT.CHIEF ELECT.INSPECTOR
CK NO CASH -
LjjCO 6 8 9 2 L JLN, 12 2 1 .75 10
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 ELECTRICAL PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS EL 0508 0606160021
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE: (626) 285-0488 ERT:
LEGAL ID: FEES PAID BUILDING ADDRESS:
TR: 6561 IT: 1 BL: .001 UN: .003 5731 RIO HONDO AV
FEE DESCRIPTION: QUANTITY: UON: AMOUNT: TEMP CA 917802433
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET:
8587-003-014 Al PERMIT ISSUANCE FEE 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY
G1 OUTLETS-LGT,SW,RECP 3.00 OUT 5.85
TENANT: HA FAU LESS 3HP 1.00 FAU 10.95 ISSUED ON: PROCESSED BY. PLAN BY: EXPIRES ON:
JH AC UNITS +3-10HP 1.00 AC 19.65 06/16/06 JK 12/13/06
TOTAL FEES 64.20
OWNER: TEL. NO: FI� B� FINAL BY: CODE:
DIEP, CONNIE P (626) 589-9078-
5731 RIO HONDO AV
TEMP 917802433 DESCRIPTION OF WORK
ELECTRICAL FOR HVAC SYSTEM
APPLICANT: TEL. NO:
SAME AS OWNER
SPECIAL CONDITIONS:
CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE
SAME AS OWNER
LIC. NO TEMPORARY POWER POLE
UNDERGROUND CONDUIT
ARCHITECT OR ENGINEER: TEL. NO: UFER GROUND
LIC. NO: ROUGH CONDUIT
ROUGH WIRING
MAIN WATER LINE
PLASTIC YIN METAL YIN
UTILITY COMPANY NOTIFIED
REPORT ID: DPR265 ROUTE TO: BS0508