HomeMy Public PortalAbout5716 ROSEMEAD BLVD_Electrical__ DOS S-A 12-44 ,APPLICATION FOR PERMIT
DEPARTI61ENT OF BUILDING AND SAFETY ��������
COUNTY OF LOS ANGELES
WM. J. FOX. CHIEF ENGINEER
Z i NAME DISTRICT NO, GROUP ZONE PERMIT NO.
_Q
U ADDRESS
UW _CITY _TEL.NO. RECEIVED BY DATE ISSUED
FIRST INSPECTION
A COUNTY
10 CERT.NO. EXPIRES
APPLICANT FILL IN HEAVILY OUTLINED
/PORTION ONLY
JOB
DESCRIPTION OF WORK ADDRESS / �+
NUMBER OF OUTLETS ON CIRCUITS LOCALITY
LOCATION BY ROOMS
NEAREST
LIGHT OUTLETS JSW. PLUGS FIXT CROSS
CIRCUIT A B C I D E IT G H W NAME y,;ILI
Z MAIL
ADDRESS .�'' •_
O
CITY TEL.NO.
1 AM THE LEGAL POSSESSOR OF THE ABOVE LOS
ANGELES COUNTY CERTIFICATE OF QUALIFICATION..
ELECTRICIAN.
I AM THE LEGAL OWNER.OF THE PROPERTY DESCRIBED
ABOVE
OWNER.
CORRECTIONS
/110
i
z
TOTAL
NO. OF OUTLETS / $ APPROVALS
NO. OF FIXTURES $ DATE INSPECTOR'S NAME.
NO. OF MOTORS H.P. $ CONDUIT A
NO. OF SIGNS TRANS. $ WIRING
NO. OF RANGES OR HEATERS $ FIXTURES
MISCELLANEOUS $ POWER
PERMIT FEE $ UTILITY CO.NOTIFIED
TATAI GFF FINAL