HomeMy Public PortalAbout5938 ROSEMEAD BLVD_Electrical__ %ou ® 'ff r ._ ° ,-iEmpc"8'CITY I
6Afb3-'eE306 11_71 APPLICATION FOR ELECTRICAL PERMIT u
COUNTY OF LOS ANGELES
DEPARTMENT OF COUNTY ENGINEER BUILDING
BUILDING AND SAFETY DIVISION ADDRESS 593 mead Blvd
LOCALITYTpmnlp city'
NEAREST
FOR APPLICANT TO FILL IN CROSS ST.
OUTLETS • NO. - EACH FEE
OWNER miLLf 1ALD
RECEPT._ $ $ MAIL
FIRST 20 25 ADDRESSahOVP
LIGHT TOTAL CITY Temple City TEL. N5-9407
SWITCH_ OVER 20 10
PLAN CHECK
LIGHTINGFIRST 20 .25 APPLICANT
TOTAL
FIXTURES
OVER .10
20 ADDRESS
RESIDENTIAL APPLIANCES CITY TEL. NO.
PERMIT
RANGE DRYER_WTR. HTR. ` APPLICAN"frane HCC
STA. COOK DISP. F.A.U. 5 L/ ADDRESS,
9034 L Peck Rcl-
SPACE HTR. AIR COND. CITY TEL. 5(7.9-7982
CLOTHES WASH. DISHWASH. LICENSE 15094 CLASg,-.10
FAN OTHER 1.00 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE-THAT THE ABOVE IS 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
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
0 - 1 1.00 LICENSED AS REQUIRED BY LOS ANGELES COUNTY AND STATE OF d
CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF, AND INTEND TO
- 1O 1 3.00 RESIDE IN, THE ABOVE DESCRIBED R SIDENTIAL PROPERTY. O
10 - 50 S00 SIGNATURE cc
OF PERMITTEE as= O
SO'- 100 10.00 j
DISTRICT NO. CLASS E - SSED BY N.1
100 - Soo 15.00 �0$ -1 , a
.q Z
SIGN, GAS SIGN AND ONE CIRCUIT 5.00 NOT€S: 1wdo �:If J6ri��e�� �ayL
TUBE, OR
MARQUEE ADDITIONAL CIRCUITS 1.00 ��1lf� e-via e-v
SERVICENOTOVER 600 VOLTS OR 200 AMP 3.00 � rj mfi' �� &fqlS�N '3-/dr'i
SERVICEOVER 600 VOLTS OR200AMP 10.00 APPROVALS DATE INSPECTOR'S SIGNATURE
TEMP.POWER POLE
TEMP SERVICE,POLE,&APPURTENANCES 5.00
TEMP LIGHT OR RECEPT. SYSTEM 3.00 UNDERSLAB WORK
ROUGH CONDI UT
WIRING
FIXTURES
ELL
(SUB TOTAL) POWER AUTHORIZED
�T- UTILITY Co. NOTIFIED
PLAN CHECK FEE
FINAL
PERMIT ISSUING FEE 3.00
TOTAL FEE
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIONCK. M.O. CASH
879'r0_ 1Ap 27 2 D - (,1 5.0 0 ,&W
SEE BACK OF APPLICATION FOR COMPLETE SCHEDULE V